Endoscopic Fundoplication With MUSE System

NCT ID: NCT03669874

Last Updated: 2020-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

80 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-09-16

Study Completion Date

2026-09-30

Brief Summary

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This is a spontaneous, prospective, monocentric, observational, cohort study, with the aim of evaluating the effect of ultrasound-guided endoscopic fundoplication using the Medigus Ultrasonic Surgical Endostapler (MUSESystem; MediGus, Ltd. Israel) in patients with esophageal or extra-esophageal gastro-oesophageal reflux disease (GERD)-related symptoms. The end of the study will be at the end of the 6-year follow-up of the last patient enrolled. The study proposes the following objectives:

* Primary objective: to evaluate the efficacy of endoscopic fundoplication with MUSE for the treatment of GERD, through clinical experience, in terms of:

* effect on GERD-Health Related Quality of Life (HRQL) and Reflux Symptom Index (RSI) questionnaire scores
* effect on the use and dosage of proton pump inhibitors (PPI)
* feasibility and safety of the endoluminal fundoplication procedure
* Secondary objective: to characterize the treated patient population (demographic and objective data) and to identify the successful predictors of the procedure.

The study design includes the following phases:

\*Preliminary patient evaluation and verification of inclusion criteria through: Upper GI endoscopy Esophageal high-resolution manometry 24-hours esophageal pH-impedance OFF PPI PPI use GERD-HRQL and RSI questionnaires scores OFF PPI

* 6-month follow-up: Upper GI endoscopy Esophageal high-resolution manometry 24-hours esophageal pH-impedance OFF PPI PPI use GERD-HRQL and RSI questionnaires scores OFF PPI
* 12-months follow-up: Upper GI endoscopy 24-hours esophageal pH-impedance OFF PPI PPI use GERD-HRQL and RSI questionnaires scores OFF PPI
* Yearly clinical follow-up (up to 6 years):

PPI use GERD-HRQL and RSI questionnaires scores OFF PPI

Detailed Description

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Conditions

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Gastro-esophageal Reflux Endoscopic Fundoplication

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Endoscopic fundoplication

Endoscopic fundoplication is a less invasive alternative to the traditional surgical fundoplication.

The MUSE device is similar to an endoscope, so the whole procedure can be done by a single operator. The device is composed of a shaft with a distal rigid part which is placed in the esophagus 3 cm proximal to the esophago-gastric junction containing a cartridge holding five B-shaped titanium surgical Staples and a tip which is retroflexed and contains an ultrasonic transducer which defines the correct tissue thickness for stapling the fundus against the esophagus. The device must be extracted to be reloaded with 5 more staples at a time for creation of a 180° anterior fundoplication.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Chronic (\> 6 months) GERD-related esophageal or extra-esophageal symptoms
* Endoscopic or pH-impedance evidence of GERD (esophagitis, Barrett's esophagus, NERD, hypersensitive esophagus)
* Indication to surgical fundoplication
* Patients available for a long-term follow-up

Exclusion Criteria

* Hiatal hernia ≥ 3 cm
* Major esophageal motility disorder
* Esophageal stenosis
* Malignant neoplasia (except minor superficial skin neoplasm)
* Portal hypertension, bleeding disorders so to controindicate surgery, esophageal varices, stenosis or diverticula
* Previous cardiac, thoracic or upper GI surgery
* BMI \>40
* Pregnancy or breast feeding
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS San Raffaele

OTHER

Sponsor Role lead

Responsible Party

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Pier Alberto Testoni

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Pier Alberto Testoni, Professor

Role: PRINCIPAL_INVESTIGATOR

San Raffaele Scientific Institute

Locations

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Pier Alberto Testoni

Milan, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Pier Alberto Testoni, Professor

Role: CONTACT

Phone: +390226432756

Email: [email protected]

Facility Contacts

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Pier Alberto Testoni, MD

Role: primary

References

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Testoni SGG, Cilona MB, Mazzoleni G, Fanti L, Ribichini E, Cavestro GM, Esposito D, Viale E, Notaristefano C, Zuppardo RA, Azzolini F, Passaretti S, Testoni PA. Transoral incisionless fundoplication with Medigus ultrasonic surgical endostapler (MUSE) for the treatment of gastro-esophageal reflux disease: outcomes up to 3 years. Surg Endosc. 2022 Jul;36(7):5023-5031. doi: 10.1007/s00464-021-08860-w. Epub 2021 Nov 19.

Reference Type DERIVED
PMID: 34799745 (View on PubMed)

Testoni PA, Testoni S, Mazzoleni G, Pantaleo G, Cilona MB, Distefano G, Fanti L, Antonelli M, Passaretti S. Transoral incisionless fundoplication with an ultrasonic surgical endostapler for the treatment of gastroesophageal reflux disease: 12-month outcomes. Endoscopy. 2020 Jun;52(6):469-473. doi: 10.1055/a-1124-3187. Epub 2020 Mar 18.

Reference Type DERIVED
PMID: 32187630 (View on PubMed)

Other Identifiers

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MUSE/2015

Identifier Type: -

Identifier Source: org_study_id