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Use of intraoperative FLIP to guide decision making in an open achalasia case: Converting an esophagectomy to a more conservative open Heller myotomy with Dor fundoplication

Open AccessPublished:November 07, 2022DOI:https://doi.org/10.1016/j.xjtc.2022.11.001
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      Intro/Abstract

      The functional luminal imaging probe (FLIP), a device developed and pioneered at Northwestern Medicine, is a diagnostic tool utilized to measure esophageal and sphincter physiology. Since its development, its use has expanded both intra- and post-operatively to directly evaluate treatment effect. However, utilization of this tool in an open esophageal case to provide real-time diameter, volumetric and pressure data, allowing for a tailored surgical intervention, has not been established in the literature. We present a novel case that demonstrates innovative use of an established diagnostic instrument that has the capacity to provide surgeons with valuable real-time intra-operative data. The authors propose intra-operative use of FLIP can support real-time surgical decision making and optimize clinical care.

      Glossary of Abbreviations:

      FLIP (functional luminal imaging probe), SMA Syndrome (superior mesenteric artery syndrome), GOO (gastric outlet obstruction), GE junction (gastroesophageal junction), POEM (peroral endoscopic myotomy), DI (Distensibility Index), POD (post operative day), EGJ (Esophagogastric junction)