Higher rates of recurrence and worse quality of life in obese patients undergoing inguinal hernia repair.

Purpose: Prior investigations regarding the effect of obesity on inguinal hernia repair have been mixed. The aim of our study was to retrospectively compare perioperative outcomes, recurrence rate, and quality of life between obese and non-obese patients undergoing inguinal hernia repair.

Methods: Patients who underwent inguinal hernia repair by any approach at a single institution were identified from a prospectively maintained quality database.

Per-Oral Plication of (Neo)Esophagus: Technical Feasibility and Early Outcomes.

Background: Endoscopic sleeve gastroplasty is an example of endoscopic sutured plications being used to remodel a gastrointestinal organ. With per-oral plication of the esophagus (POPE), similar plications are used to remodel the dilated and redundant megaesophagus of end-stage achalasia. Redundancies and dilations can also develop in the neoesophagus of a patient with prior esophagectomy.

A Tailored Approach to Laparoscopic Fundoplication: Outcomes in Patients with Esophageal Dysmotility.

Background: Esophageal dysmotility is a common finding in patients being evaluated for antireflux surgery, although its implication remains unclear. We aimed to evaluate outcomes of patients with esophageal dysmotility after fundoplication.

Methods: A retrospective review of a prospective quality-database was performed.

Identification of 14 novel susceptibility loci for diaphragmatic hernia development and their biological and clinical implications: results from the UK Biobank.

Introduction: Genetic contributions to hernia development are incompletely understood. This study performed the first comprehensive genome-wide association study (GWAS) for diaphragmatic hernia using a large population-based cohort in the UK Biobank (UKB).

Methods And Procedures: Two-stage GWAS (discovery and confirmation) was performed for diaphragmatic hernia in the UKB.

Laparoscopic and robotic inguinal hernia repair are safe and effective after prior pelvic or low abdominal surgery.

Background: The ideal approach to inguinal hernia repair (IHR) after prior pelvic or low abdominal surgery is not agreed upon. We compared safety and outcomes of IHR between open, laparoscopic, and robotic approaches.

Methods: This retrospective review of a prospective database analyzed demographic, perioperative, and quality of life data for patients who underwent IHR after pelvic or low abdominal surgery.

Impedance Planimetry (Endoflip) and Ideal Distensibility Ranges for Optimal Outcomes after Nissen and Toupet Fundoplication.

Background: Previous research has shown that impedance planimetry-based functional lumen imaging probe (FLIP) measurements are associated with patient-reported outcomes after laparoscopic antireflux surgery. We hypothesize that Nissen and Toupet fundoplications have different ideal FLIP profiles, such as distensibility.

Study Design: A retrospective review of a prospectively maintained quality database was performed.

Changes in impedance planimetry (EndoFLIP) measurements at follow-up after peroral endoscopic myotomy (POEM).

Background: Numerous studies show changes in functional lumen imaging probe (FLIP) measurements after myotomy during peroral endoscopic myotomy (POEM), but few report on FLIP measurements at follow-up esophagogastroduodenoscopy (EGD). The purpose of this study was to compare perioperative FLIP measurements to those at follow-up EGD.

Methods: Patients who underwent POEM with FLIP in the operating room and POEM patients who had EGD with FLIP at follow-up were included.

Impedance planimetry (EndoFLIP™) after magnetic sphincter augmentation (LINX®) compared to fundoplication.

Introduction: Functional luminal imaging probe (FLIP) use during laparoscopic fundoplication (LF) for gastroesophageal reflux disease is well described. However, there is a lack of data on FLIP measurements during magnetic sphincter augmentation (MSA). This study aims to report our institutional experience in performing FLIP during MSA and to compare these measurements to those obtained during Nissen and Toupet fundoplication.

Patient-reported bowel and bladder function is not adversely impacted by bariatric surgery.

Introduction: This study aims to assess the effect of bariatric surgery on patient-reported outcomes of bowel and bladder function. We hypothesized that bariatric surgery does not worsen bowel and bladder function.

Methods And Procedures: A retrospective review was conducted of a prospectively maintained surgical quality database.

A modular simulation curriculum to teach endoscopic stenting to practicing surgeons: an "Into the fire" approach.

Background: Flexible endoscopy is a valuable tool for the gastrointestinal (GI) surgeon, creating a need for effective and efficient training curricula in therapeutic endoscopic techniques for trainees and practicing providers. Here, we present a simulation-based modular curriculum using an "into the fire" approach with hands-on pre- and post-testing to teach endoscopic stenting to practicing surgeons.

Methods: Three advanced flexible endoscopy courses were taught by expert surgical endoscopists from 2018 to 2019.

Impedance planimetry (EndoFLIP™) reveals changes in gastroesophageal junction compliance during fundoplication.

Introduction: Compliance is the ability of a hollow organ to dilate and increase volume with an increase in pressure, an accurate representation of food bolus transit through the gastroesophageal junction (GEJ). Impedance planimetry system can calculate compliance (change in volume over pressure) and distensibility (cross-sectional area over pressure) of the GEJ. We aim to describe the changes in compliance during anti-reflux surgery and hypothesize that compliance is a better predictor of patient outcomes than distensibility (DI).

Impedance planimetry (EndoFLIP) measurements persist long term after anti-reflux surgery.

Purpose: The functional lumen imaging probe provides objective measurements of the gastroesophageal junction during laparoscopic anti-reflux surgery. There is a lack of data on how functional lumen imaging probe measurements change at follow-up. We aim to describe our institutional experience in performing functional lumen imaging probe during postoperative endoscopy after laparoscopic anti-reflux surgery.

Impedance Planimetry (Endoflip™) Shows That Length of Narrowing After Fundoplication Does Not Impact Dysphagia.

Introduction: A short floppy fundoplication has been the surgical dogma to prevent dysphagia and gas-bloat after laparoscopic fundoplication while adequately addressing gastroesophageal reflux disease. The literature on the ideal length of narrowing (LON) of the gastroesophageal junction after fundoplication is sparse. The functional luminal imaging probe (FLIP) can be used during anti-reflux surgery to produce a visual representation of the LON.

Crural closure, not fundoplication, results in a significant decrease in lower esophageal sphincter distensibility.

Introduction: The esophagogastric junction (EGJ) is a complex anti-reflux barrier whose integrity relies on both the intrinsic lower esophageal sphincter (LES) and extrinsic crural diaphragm. During hiatal hernia repair, it is unclear whether the crural closure or the fundoplication is more important to restore the anti-reflux barrier. The objective of this study is to analyze changes in LES minimum diameter (D) and distensibility index (DI) using the endoluminal functional lumen imaging probe (FLIP) during hiatal hernia repair.

Teaching EndoFLIP Impedance Planimetry to Practicing Endoscopists: An "Into the Fire" Approach to Simulation.

There are growing interests from practicing endoscopists to implement the functional lumen imaging probe (FLIP) impedance planimetry system. We present a simulation-based curriculum using an "into the fire" approach with hands-on pre- and post-tests to teach the use of this technology. The curriculum consists of a series of pre-tests, didactic content, mentored hands-on instructions, and post-tests.

Inguinal hernia mesh is safe in 1720 patients.

Background: There is substantial media and patient interest in the safety of mesh for hernia repair. However, there is a lack of data regarding health-related quality of life (HRQOL) outcomes in patients who undergo inguinal hernia repair (IHR) with mesh. The purpose of this study is report short and long-term postoperative quality of life outcomes in patients following IHR with mesh.

Mesh in Elective Hernia Repair: 10-Year Experience with over 6,000 Patients.

Background: The use of mesh in hernia repair has faced intense scrutiny, leading patients to become fearful of its use, despite its benefits in reducing hernia recurrence. We report a single institutional experience in performing hernia repair with mesh in terms of hernia-specific outcomes, mesh-related complications, and patient-reported quality of life.

Study Design: Patients who underwent abdominal wall hernia repair with mesh at a single institution were identified from a prospectively maintained quality database.

Significant changes in impedance planimetry (EndoFLIP™) measurements after peroral pyloromyotomy for delayed gastric emptying.

Background: The endoluminal functional lumen imaging probe (FLIP) can be used to obtain real-time measurements of the diameter (D), cross-sectional area (CSA), and distensibility of the pylorus before and after peroral pyloromyotomy (POP), an emerging endoscopic treatment for delayed gastric emptying. Our study aims to report our single-center experience in performing POP with FLIP measurements before and after pyloromyotomy.

Methods: A retrospective review of a prospectively maintained gastroesophageal database was performed.

Anti-reflux mucosectomy (ARMS) results in improved recovery and similar reflux quality of life outcomes compared to laparoscopic Nissen fundoplication.

Background: Anti-reflux mucosectomy (ARMS) is a new endoscopic procedure involving a hemi-circumferential endoscopic mucosal resection (EMR) around the gastroesophageal junction. We aim to compare perioperative and quality of life outcomes of patients with reflux who underwent ARMS to a comparable group who underwent laparoscopic Nissen fundoplication (NF).

Methods: A retrospective review of a prospectively maintained quality database was performed.

Comparing cost and outcomes between peroral endoscopic myotomy and laparoscopic heller myotomy.

Background: Peroral endoscopic myotomy (POEM) has previously been shown to be equally if not more expensive than laparoscopic Heller myotomy (LHM). We compare perioperative outcomes and charges between POEM and LHM at a single institution.

Methods: Outcomes and charge data of 33 patients who underwent LHM and 126 patients who underwent POEM were analyzed.

Impact of prior treatment on feasibility and outcomes of Zenker's peroral endoscopic myotomy (Z-POEM).

Background: Zenker's peroral endoscopic myotomy (Z-POEM) is a novel procedure for the management of symptomatic Zenker's diverticulum. This study aims to report the technical feasibility and outcomes of Z-POEM in the management of Zenker's diverticulum after prior failed interventions.

Methods: Patients with persistent or recurrent symptoms after prior endoscopic and/or surgical intervention for Zenker's diverticulum were retrospectively included.

Teaching peroral endoscopic pyloromyotomy (POP) to practicing endoscopists: An "into-the-fire" approach to simulation.

Background: Peroral endoscopic pyloromyotomy, or gastric peroral endoscopic myotomy, is a novel endoscopic procedure for the treatment of refractory gastroparesis. We present a simulation-based curriculum using an "into-the-fire" approach with hands-on pre- and post-tests to teach this procedure.

Methods: Six, 1-day peroral endoscopic pyloromyotomy courses were taught by an expert surgical endoscopist in 2018 to 2019.

Predictors of chronic pain after laparoscopic inguinal hernia repair.

Background: Multiple studies have analyzed predictors for chronic pain after open hernia repair. The purpose of this study is to determine which factors predict the development of chronic pain after a laparoscopic inguinal hernia repair.

Methods: We identified patients who underwent laparoscopic inguinal hernia repair between 2008 and 2020 at a single institution.

Using a standardized intra-operative endoflip protocol during fundoplication to identify factors that affect distensibility.

Introduction: The Endoluminal Functional Lumen Imaging Probe (Endoflip) can be used to provide objective measurements of the gastroesophageal junction during fundoplication, and recent publications have suggested that this device could improve surgical outcomes. However, the impact of operative variables has not been clearly reported. The aim of this study is to determine the effect of these variables on functional lumen imaging probe (FLIP) measurements.