Abstract
EndoFLIP technology, utilizing impedance planimetry, has revolutionized the assessment
of gastrointestinal sphincters by providing real-time measurements of cross-sectional
area and pressure to calculate distensibility. This review explores its application
in de novo and revisional foregut surgeries. Preoperatively, EndoFLIP has demonstrated
efficacy in evaluating gastroesophageal reflux disease, hiatal hernia, and esophageal
motility disorders, including achalasia, by distinguishing motility patterns and identifying
sphincter incompetence. In gastroparesis, EndoFLIP's measurement of pyloric distensibility
correlates with gastric emptying and symptom severity, guiding therapeutic decisions
for pyloric interventions. Intraoperatively, EndoFLIP optimizes surgical outcomes
in antireflux procedures, such as fundoplication and hiatal hernia repairs, by balancing
effective reflux control with minimizing postoperative complications like dysphagia
and gas bloat. For esophageal myotomy, including Heller myotomy and per oral endoscopic
myotomy, EndoFLIP ensures adequate sphincter relaxation, reducing reflux risks. Additionally,
during endoscopic pyloromyotomy for gastroparesis, EndoFLIP predicts clinical success
by assessing postprocedural distensibility. While promising, further research is essential
to establish standardized intraoperative protocols and ideal measurement targets,
enhancing the reproducibility and accuracy of EndoFLIP applications. Overall, EndoFLIP
offers a significant advancement in foregut surgery, improving diagnostic precision
and therapeutic outcomes.
Keywords
endoFLIP - esophagus - gastroparesis - achalasia - gastroesophageal reflux disease
