Focusing on the Gastroesophageal Reflux Disease, Shanghai General Hospital Jointly Launched the Clinical Innovative Research Application by Completing the First New Generation of Miaosi Ultrasonic Surgical Endostapler

  Recently,Professor Wan Rong,executive director of the Department of Gastroenterology, performed the first new generation of Miaosi Ultrasonic Surgical Endostapler on a patient who had been suffering from gastroesophageal reflux disease for many years.

  To overcome the problem of moderate-to-severe gastroesophageal reflux disease, Shanghai General Hospital has led many hospitals to jointly carry out a multi-center study on “The establishment and clinical promotion of an endoscopic minimally invasive diagnosis and treatment system for moderate-to-severe gastroesophageal reflux disease”. The project is one of the three-years action plan (2020-2022) of Shanghai Hospital Development Center for promoting clinical skills and clinical innovation ability of municipal hospitals, to study, evaluate, and determine the efficacy and safety of Miaosi Ultrasonic Surgical Endostapler for gastroesophageal reflux disease, to establish a standardized clinical diagnosis and treatment system for moderate-to-severe gastroesophageal reflux disease, and to promote its clinical application.

  According to reports, repeated episodes of gastroesophageal reflux disease can lead to reflux esophagitis and damage to the adjacent tissues of the esophagus, such as the throat and airway. Patients often feel a burning discomfort after the sternum, and may also experience symptoms such as chest pain and dysphagia, some gastroesophageal reflux disease patients may also develop chronic pharyngitis, cough, asthma, and other symptoms due to stimulation of the esophagus by reflux. At present, the standard anti-reflux surgery is the laparoscopic fundoplication, but the laparoscopy anti-reflux surgery needs to separate the fundus and the lower part of the esophagus. The Miaosi Ultrasonic Surgical Endostapler passes through the oral cavity through the esophagus to the stomach without any incision. The operation time can be shortened from 2-3 hours to about 1 hour, the normal length of hospital stay was reduced from 1 to 2 weeks to about 3 days.

  On the day of the operation, Professor Wan inserted endoscopy through a gastroscope cannula into the patient’s esophagus. Through the camera’s field of view, the endoscope quickly reaches the fundus of the stomach, and is guided by an endoscopically fused compass system to precisely locate and select the right fixation point. The tip of the endoscope is then bent up, folding part of the fundus upward. At this point, the camera is covered by the fundus of the stomach, and the location is turned over to the ultrasound device. By ultrasonic sensing, the nail slot at the top of the endoscope is positioned between the folded gastric fundus and the nail box at the distal end to ensure that the titanium nail in the nail box is on the same line as the nail slot. The titanium nail was then fired from the nail box, pinning the end of the esophagus to the folded fundus, and then Professor Wan performed the same procedure in two other places. At this point, the patient’s gastric fundus has been folded up, attached to the end of the esophagus, forming a perfect v-shaped valve flap, blocking the reflux acid into the esophagus, the surgery was successful.

  It is worth mentioning that, the “Miaosi Ultrasonic Surgical Endostapler”was developed and manufactured by Miaosi Medical Technology (Shanghai) , jointly supported by the research team and G60 Science and innovation corridor of Songjiang District, this is also the first generation of China’s own innovation of the chinese-made MUSE endoscopic fundoplication system. It not only breaks the technology monopoly of foreign medical device enterprises in this field, but also reduces the operation cost of patients by about 50% .

  It is reported that, the three-year action plan (2020-2022) of Shanghai Shenkang Hospital Development Center aims to guide and fund standardized clinical research in municipal hospitals with clinical application value and Good Foundation for early research. The project, “The establishment and clinical promotion of an endoscopic minimally invasive diagnosis and treatment system for moderate-to-severe gastroesophageal reflux disease,”will be led by the research team at the Shanghai General Hospital, the prospective, multi-center, single-arm, non-blind intervention study was carried out in three sub-centers, namely the Zhongshan Hospital , the Ruijin Hospital, the Renji Hospital.

(Correspondent: Jiang Weiliang, Wan Rong, Department of Gastroenterology)