Safe implementation of transoral incisionless fundoplication as a new technique in a tertiary care center

Shivanand Bomman; Sofya Malashanka; Adil Ghafoor; David J. Sanders; Shayan Irani; Richard A. Kozarek; Andrew Ross; Michal Hubka; Rajesh Krishnamoorthi

doi:10.5946/ce.2022.003

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자료유형: 학술저널

저자정보: Shivanand Bomman (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) Sofya Malashanka (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) Adil Ghafoor (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) David J. Sanders (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) Shayan Irani (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) Richard A. Kozarek (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) Andrew Ross (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) Michal Hubka (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA) Rajesh Krishnamoorthi (Center for Digestive Health Virginia Mason Franciscan Health Seattle WA USA)

저널정보: 대한소화기내시경학회 Clinical Endoscopy Clinical Endoscopy 제55권 제5호

발행연도: 2022.9

수록면: 630 - 636 (7page)

DOI: 10.5946/ce.2022.003

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Background/Aims: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution’s programmatic allocation of resources during the safe implementation of TIF as a new procedure. Methods: A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was per- formed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and out- comes were evaluated during transition. Results: Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine esophagogram. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure dura- tion was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02). Conclusions: A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effec- tive transition to a fully outpatient procedure.

#Gastroesophageal reflux disease #Health resources #Implementation #Transoral incisionless fundoplication

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