Innovative Device Reconstructs Gastroesophageal Reflux Barrier

A novel transoral endoscopic system enables physicians to rebuild the gastroesophageal valve (GEV) with a partial fundoplication technique.

The EndoGastric Solutions (Redmond, WA, USA) EsophyX Z+ device offers patients who need to undergo an anatomical repair of the GEV an effective treatment option to correct severe gastroesophageal reflux disease (GERD). The device enables the creation of a 2-3 cm, 270° esophagogastric fundoplication, using the transoral incisionless fundoplication (TIF) technique. A flexible video endoscope is first inserted into the central lumen of the EsophyX device to provide direct visualization throughout the TIF procedure.


A helical retractor is then used to retract tissue and anchor the gastroesophageal junction during the fundoplication. It then stows away safely inside the tissue mold during insertion and removal. The next stage involves the Tissue Mold and Chassis, which plicates and compresses the tissue and rotates the fundus around esophagus to create a partial wrap. An Invaginator then suctions the tissue to reduce the small hiatal hernia, facilitating positioning of the fundoplication caudal to the diaphragm. Finally, stylets and SerosaFuse fasteners are used to transect the apposed tissues and maintain tissue compression throughout the healing process.

“We are excited to launch the EsophyX Z+ device, as we believe it will further enhance the physician’s technical experience,” said Skip Baldino, President and CEO of EndoGastric Solutions. “At EndoGastric Solutions, we are committed to addressing the unmet needs in gastrointestinal diseases and offering physicians highly effective options that fill the significant treatment gap between medication and more invasive surgery.”

“GERD is a chronic condition, and proton pump inhibitors do not control symptoms in about one-third of patients,” said surgeon Michael Murray, MD, of Northern Nevada Medical Center (Sparks, NV, USA). “The design of the new EsophyX Z+ device makes performing TIF 2.0 procedures technically easy, and produces a consistent and effective fundoplication, providing an effective alternative to prescription medications and traditional surgical procedures.”

GERD is a chronic condition in which the GEV allows gastric contents to reflux into the esophagus, causing heartburn and possible injury to the esophageal lining. In most GERD patients, the esophageal sphincter is weakened and does not close tightly, allowing digestive juices to return and irritate the esophageal lining. Fundoplication, which involves folding and reinforcing the annulus between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus, can help restore the compromised reflux barrier.

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