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

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 (D min) 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.