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Tailored Fundoplication With Endoluminal Functional Lumen Imaging Probe Allows for Successful Minimally Invasive Hiatal Hernia Repair

Kim, Min, P., MD, FACS*,†; Meisenbach, Leonora, M., MSN, RN, ACNP*; Chan, Edward, Y., MD, FACS*,†

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: June 2018 - Volume 28 - Issue 3 - p 178–182
doi: 10.1097/SLE.0000000000000527
Original Articles

Endoluminal functional lumen imaging probe (EndoFLIP) can provide real time information about characteristics of the gastroesophageal junction. We performed retrospective analysis of prospectively collected data on use of EndoFLIP during minimally invasive hiatal hernia repair to tailor the size of the crural closure and size of the fundoplication. We then determined whether it provides good reflux control without significant dysphagia. Forty patients underwent minimally invasive hiatal hernia repair with fundoplication. After fundoplication, the average minimal diameter (Dmin) decreased to 5.97±0.6 from 8.92±1.93 mm, and distensibility index decreased to 1.26±0.38 from 2.88±1.55 mm2/mm Hg (P<0.0001). After 1 month, none of the patients had reflux or significant dysphagia. EndoFLIP can be used to tailor fundoplication with good functional outcome. Further studies are needed to understand the long-term consequences of tailored fundoplication.

*Department of Surgery, Division of Thoracic Surgery

Department of Surgery, Weill Cornell Medical College, Houston Methodist Hospital, Houston, TX

M.P.K. has consulted for Medtronics, Boston Scientific, Olympus, and Intuitive Surgical. E.Y.C. has consulted for Medtronics, Boston Scientific, and Olympus. L.M.M. declares no conflicts of interest.

Reprints: Min P. Kim, MD, FACS, 6550 Fannin Street, Suite 1661, Houston, TX 77030 (e-mail:

Received December 15, 2017

Accepted February 27, 2018

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