Endoflip® system for Impedance Planimetry

EndoFLIP is a new imaging tool which employs a balloon catheter within which there is an array of electrodes, along with a balloon pressure sensor.

Using a technique known as impedance planimetry, the diameter at each electrode on the catheter can be estimated. When the balloon catheter is inserted into a hollow body an image, extending up to 80mm long, may be constructed in 5mm slices.

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OVERVIEW


EndoFLIP® Technology


The EndoFLIP® (Endolumenal Functional Lumen Imaging Probe) Imaging System is a revolutionary new technology used to measure the dimensions and function of a variety of hollow organs and sphincteric regions throughout the gastrointestinal tract.

These measurements are useful for different types of patients such as:











                      • GORD patients























                      • Potential candidates for GORD surgery























                      • Bariatric surgery patients












Impedance Planimetry


By measuring pressure, "distensibility” can be calculated using the formula cross sectional area/balloon pressure. This indicates how much a stoma or sphincter stretches when challenged by the balloon when it is inflated to a given pressure.

This "compliance-like" figure differs from compliance, calculated as volume/pressure, which is more appropriate to a closed volume, such as a pouch for example. See below for example.

Impedance monitoring will have broad applications for gastroenterologists as well as those performing anti-reflux procedures. Impedance monitoring removes the need for assumptions by showing the actual bolus transit.

Seting Up EndoFLIP (part 1)




Seting Up EndoFLIP (part 2)




FLIP Analytics tool demonstration





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PAPERS


Title:Esophagogastric Junction Distensibility After Fundoplication Assessed with a Novel Functional Luminal Imaging Probe
Author(s):Monika A. Kwiatek, Peter J. Kahrilas, Nathaniel J. Soper, William J. Bulsiewicz, Barry P. McMahon, Hans Gregersen and John E. Pandolfino
Ref:J Gastrointest Surg DOI 10.1007/s11605-009-1086-1






Title:Do we really understand the role of the oesophagogastric junction in disease?
Author(s):Barry P McMahon, Blair A Jobe, John E Pandolfino and Hans Gregersen
Ref:World J Gastroenterol 2009 January 14; 15(2): 144-150






Title:Esophagogastric junction distensibility: a factor contributing to sphincter incompetence
Author(s):John E Pandalfino, Guoxiang Shi, Jennifer Curry, Raymond J Joehl, James G Brasseur and Peter J Kahrilas
Ref:Am J Physiol Gastrointest Liver Physiol 282: G1052–G1058, 2002; 10.1152/ajpgi.00279.2001.






Title:Esophagogastric junction opening during relaxation distinguishes nonhernia reflux patients, hernia patients and normal subjects
Author(s):John E Pandalfino, Guoxiang Shi, Brian Trueworthy and Peter J Kahrilas
Ref:Gastroenterology 2003;125:1018–1024






Title:Functional oesophago-gastric junction imaging
Author(s):Barry P McMahon, Asbjørn M Drewes and Hans Gregersen
Ref:World J Gastroenterol 2006 May 14; 12(18): 2818-2824






Title:Increased esophagogastric junction distensibility in GERD patients assessed with the endoscopically placed functional luminal imaging probe - abstract
Author(s):Monika A Kwiatek, Ikuo Hirano, Peter J Kahrilas, Barry McMahon and John E Pandolfino
  






Title:Restoration of normal distensive characteristics of the esophagogastric junction after fundoplication
Author(s):John E Pandolfino, Jennifer Curry, Guoxiang Shi, Raymond J. Joehl, James G. Brasseur and Peter J. Kahrilas
Ref:Ann Surg 2005;242: 43–48






Title:The functional lumen imaging probe (FLIP) for evaluation of the esophagogastric junction
Author(s):Barry P McMahon Jens B Frøkjær, Peter Kunwald, Donghua Liao, Peter Funch-Jensen, Asbjørn M. Drewes, and Hans Gregersen
Ref:Am J Physiol Gastrointest Liver Physiol 292: G377–G384, 2007.






Title:A new technique for evaluating sphincter function in visceral organs: application of the functional lumen imaging probe (FLIP) for the evaluation of the oesophago-gastric junction
Author(s):Monika A. Kwiatek, Ikuo Hirano, Daniel Luger, Peter J., Kahrilas, Nirmala Gonsalves and John E. Pandolfino
  






Title:The relationship between symptom response, esophageal eosinophilia and wall distensibility in eosinophilic esophagitis - A pilot study following proton pump inhibitor therapy
Author(s):Monika A. Kwiatek, Ikuo Hirano, Daniel Luger, Peter J. Kahrilas, Nirmala Gonsalves and John E. Pandolfino