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Novel Applications for EndoFLIP in Foregut Surgery

Surgery to correct conditions in the foregut, such as hiatal hernia and achalasia, has historically relied on surgeons’ preferences for different techniques rather than objective parameters, which creates considerable variability in outcomes for patients. Min Kim, MD, David M. Underwood Distinguished Professor of Surgery and Head of the Division of Thoracic Surgery, seeks to establish an objective, data-driven foundation for these procedures by leveraging innovative technologies to determine parameters that consistently ensure the best surgical outcomes. For the past several years, Dr. Kim has used an endoluminal functional lumen imaging probe (EndoFLIP) device—which provides real-time data about how tight the area between the esophagus and stomach is—during every surgery to collect measurements and correlate them with patient outcomes, thus providing optimal distensibility index (DI) ranges to reach by the end of surgery.
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Min Kim, MD, David M. Underwood Distinguished Professor of Surgery and Head of the Division of Thoracic Surgery
In achalasia, a rare disorder of the esophagus that makes it difficult for food and liquid to pass into the stomach, Dr. Kim has identified a threshold DI for the esophageal muscle that allows real-time diagnosis of achalasia mid-surgery and defines parameters that ensure good outcomes. “Now, I leave the operating room knowing, 100%, they’re going to be great,” Dr. Kim says. “As a surgeon, there’s nothing better than that.” Hiatal hernia is more complicated, as how well a patient’s esophagus functions affects the optimal DI to target for that patient, but Dr. Kim is confident that collecting and analyzing data from more patients will ultimately establish a set of objective parameters to guide surgeons in repairing this condition as well.