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Safety and Efficacy the Medigus SRS Endoscopic Stapling System in Gastroesophageal Reflux Disease (GERD)

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ClinicalTrials.gov Identifier: NCT00734747
Recruitment Status : Completed
First Posted : August 14, 2008
Results First Posted : August 14, 2015
Last Update Posted : February 2, 2016
Sponsor:
Information provided by (Responsible Party):
Aviel Roy-Shapira, M.D., Medigus Ltd

Brief Summary:

The study is designed to test the safety and efficacy of the Medigus SRS endoscopic stapling system for the treatment of GERD.

The system allows the operator to staple the stomach to the esophagus,in order to restore the gastroesophageal flap valve. The effect of the stapling is similar to a common operation for GERD (partial fundoplication) but is done through the mouth, and incision into the abdomen is not needed.

The hypothesis of the study is that the treatment will be effective in improving GERD related quality of life by 50% or more in the majority of the subjects, and that the procedure will be as safe as surgery.


Condition or disease Intervention/treatment Phase
Gastroesophageal Reflux Disease (GERD) Device: Medigus SRS endoscopic stapling system Phase 3

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 72 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Evaluation of the Medigus SRS Endoscopic Stapling System for the Treatment of Gastro-Esophageal Reflux Disease (GERD)
Study Start Date : May 2008
Actual Primary Completion Date : May 2011
Actual Study Completion Date : July 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Endoscopy GERD
U.S. FDA Resources

Arm Intervention/treatment
Experimental: Medigus SRS Endoscopic Stapling System
Endoluminal fundoplication for the treatment of GERD
Device: Medigus SRS endoscopic stapling system
The system is designed to staple the stomach to the esophagus in 2 or 3 locations using a quintuplet of standard B shaped, 4.8 mm titanium staples in each location.
Other Names:
  • endoluminal treatment of GERD
  • Incisionless treatment of GERD



Primary Outcome Measures :
  1. Percentage of Participants With >= 50% Improvement in GERD Health Related Quality of Life (GERD-HRQL - Velanovich) Score [ Time Frame: Six months ]
    Gastroesophageal Reflux Disease Health Related Quality of Life (GERD-HRQL) questionnaire, also known as Velanovich score. The questionnaire consists of 10 questions with responses of 0-5. The responses of the 10 questions are totaled (range of 0-50) where a higher total indicates more severe disease than a lower total. This questionnaire was administered while the subjects were not taking proton pump inhibitor (PPI) medication (i.e. off-PPI). Criterion for success was an improvement >= 50% compared to baseline, at six months post procedure in at least 53% of the subjects (53% is the lower boundary of the 95% confidence interval)

  2. Serious Adverse Events (SAEs) [ Time Frame: 6 months ]
    The primary safety endpoint consisted of all treatment-related adverse events, during and after the SRS procedure. The primary safety endpoint consisted of all treatment-related adverse events, during and after the SRS procedure. "Treatment-related" events were conventionally defined as those which occurred in the first 30 days post-procedure. The SAEs presented here include all SAEs from the study, including one that occurred 35 days post-procedure (suicidal behavior). There was an interim review of early Serious Adverse Events (SAEs) after the first 24 patients. Protocol and device changes were then implemented, prior to the final 48 patients. Therefore, the SAEs are presented in two categories consisting of the first 24 patients and the final 48 patients.


Secondary Outcome Measures :
  1. Reduction of Acid Exposure (%Time pH<4) on Off PPI Ambulatory 24h Acid Exposure Test [ Time Frame: 6 months ]
    Esophageal pH (off PPI therapy) was measured in 66 patients pre-procedure and 64 patients at 6 months post-procedure

  2. Reduction of Proton Pump Inhibitor (PPI) Use, as Reported by Subject [ Time Frame: 6 months ]


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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • History of GERD related symptoms for at least 2 years.
  • Recent objective evidence of GERD, demonstrated by a 24h pH acid exposure test.
  • History of daily intake of proton pump inhibitors (PPIs) for at least 6 months, with significant relief of symptoms (i.e., difference in GERD Health Related Quality of Life (GERD HRQL) scores on and off PPI > =6).
  • GERD-HRQL ≥20 off of PPI's

Exclusion Criteria:

  • Hiatal hernia > 3 cm or a paraesophageal hernia
  • Barrett's esophagus or grade IV esophagitis
  • Esophageal stricture, ring or web causing symptoms of dysphagia
  • Grade I Flap valve according Hill's classification
  • History of co-morbidity

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00734747


Locations
United States, California
UC San Diego
San Diego, California, United States, 92103-8401
United States, Indiana
Indiana University Hospital
Indianapolis, Indiana, United States, 46202
Austria
Akh Vienna City General Hospital
Vienna, Austria, A-1090
Germany
Med.Klinik Universitatsmedizin
Mainz, Germany
India
Deenanath Mangeshkar Hospital and Medical Research Center
Pune, India
Italy
Medical University of Milan - San Donato Hospital
Milan, Italy
Sponsors and Collaborators
Aviel Roy-Shapira, M.D.
Investigators
Study Director: Aviel Roy-Shapira, M.D. Medigus Ltd

Publications of Results:
Responsible Party: Aviel Roy-Shapira, M.D., Study director, Medigus Ltd
ClinicalTrials.gov Identifier: NCT00734747     History of Changes
Other Study ID Numbers: DCLP09002
First Posted: August 14, 2008    Key Record Dates
Results First Posted: August 14, 2015
Last Update Posted: February 2, 2016
Last Verified: December 2015

Keywords provided by Aviel Roy-Shapira, M.D., Medigus Ltd:
GERD
Gastroesophageal Reflux
Fundoplication
Endoluminal
Gastroesophageal Flap Valve

Additional relevant MeSH terms:
Gastroesophageal Reflux
Esophageal Motility Disorders
Deglutition Disorders
Esophageal Diseases
Gastrointestinal Diseases
Digestive System Diseases