Abstract
Background and study aims This preliminary study was conducted to determine the feasibility and safety of endoscopic
augmentation of the gastroesophageal junction (GEJ) using the Apollo OverStitch endoscopic
suturing system in patients with gastroesophageal reflux disease (GERD) symptoms.
Patients and methods Endoscopic augmentation of GEJ was performed on 10 consecutive patients and the data
were analyzed retrospectively. Using a double-channel gastroscope affixed to the endoscopic
suturing platform, interrupted sutures were placed on the gastric side of the GEJ
in 2 layers in order to create a narrowed and elongated GEJ.
Results Technical success was achieved in all patients, including those with a history of
previous antireflux procedures (n = 7) and those with a hiatal hernia (n = 6). The
median follow-up duration was 5 mo (range: 2 – 12). The median pre-procedure GERD-Health
Related Quality of Life Questionnaire improved from 20 (range: 11 – 45) to a post-procedure
score of 6 (range: 3 – 25) (P = 0.001). The median duration of GERD symptom improvement after the procedure was
1 mo (range: 0.5 – 4). Adverse events were limited to 1 patient who developed nausea
and vomiting, which was self-limited.
Conclusions The use of a novel endoscopic suturing technique for the treatment of GERD is feasible
and safe. The procedure resulted in short-term GERD symptom improvement. Further prospective
studies using refined techniques are currently underway to improve durability and
to prove efficacy.
