The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on endoscopic augmentation of the lower oesophageal sphincter using hydrogel implants for the treatment of gastro-oesophageal reflux disease in June 2007. In accordance with the Interventional Procedures Programme Process Guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.
The guidance was considered for reassessment in June 2010 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.
June 2016 – Please note that the device linked to this guidance has been withdrawn by the manufacturer. Further information can be found at gov.uk’s alerts and recalls for drugs and medical devices. NICE may review this guidance should additional information be made available.
An overtube and implant delivery mechanism is endoscopically guided to the gastro-oesophageal junction. Suction is applied to pull a fold of the oesophageal wall into the overtube. Saline is injected into this fold to create a space within the submucosa, and one or more hydrogel prostheses are implanted. The prostheses absorb water and expand to create a fold in the oesophageal wall bulking the oesophagus and preventing gastro-oesophageal reflux.
G44.1 Fibreoptic endoscopic insertion of prosthesis into upper gastrointestinal tract
Includes: Endoscopic insertion of expanding metal stent into upper gastrointestinal tract
O11.1 Gastro-oesophageal junction
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.