Ideas for creating your own LES valve

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   Posted 12/1/2012 10:09 PM (GMT -6)   
After watching and thinking for a bit, it does feel like a valve (Like LES) should be a straightforward concept.

May be it is because I am an engineer, but am I alone in wondering why in 2012 we can't make a valve ? No disrespect, but Fundo feels like an OVERKILL for a simple valve, doesn't it ?


My idea is a post-implant pressure adjustable device operated by a remote control: open it when you need to eat/burp, close otherwise. In time, it can be improved so that close/open are triggered based on esophageal contractions.

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Date Joined Dec 2011
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   Posted 12/1/2012 10:24 PM (GMT -6)   
I know. Seems like it should be a no brainer to create a valve rather than stapling it, or rearranging all of your internal organs for "support". Many nights I've dreamed of being able to tie a string around my LES to cinch it closed--I think something that could stay closed unless you wanted it opened, would be great.

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   Posted 12/1/2012 10:44 PM (GMT -6)   
I often press on my stomach to try and close off the valve. Sometimes it seems like it works haha doubt it though

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   Posted 12/1/2012 11:23 PM (GMT -6)   
Well....It's a great thought, but there is one flaw in your thinking. Unfortunately you would spend a lot of time opening and closing the valve. It not only has to open when you eat or drink, but must also open during normal swallowing of saliva.
Trust me, it's not pleasant to be bringing all that back up like a hairball. LOL!

Interesting concept though.

Take care,
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

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   Posted 12/2/2012 4:47 AM (GMT -6)   
Hi Bill,

Good point, but it can be worked around.

The problem with today's valves are they are not pressure adjustable post implant (LINX) or surgery (Nissen). So, surgery either works or doesn't work.

I think a device that has a fixed pressure (like LINX) with the ability to add/decrease to that pressure to a certain extent with a click will be ideal.

Imagine a Ring shaped device with (a) pressure sensors above and below the LES (b) ability to increase/decrease the radius (valve pressure) by a controller.

I would imagine a few days of pressure data is good enough to tune the control logic.


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   Posted 12/2/2012 7:41 AM (GMT -6)   
The other approach would be to figure out how to control the gas, that was putting too much pressure on this valve. This would not be an engineering problem, but a digestive one. The ppis don't address this.

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   Posted 12/2/2012 3:47 PM (GMT -6)   
I like your idea, and also find it very frustrating that we all continue to suffer in this day and age, when technology is supposedly at its optimum, why has such a valve (or similar product) not been created?
I thought Endostim was a step towards this, perhaps I am misinformed. Perhaps you could get your engineers hat on and see what you could come up with, as no one else in the medical community seems remotely interested.
Perhaps if we all pitch in ideas, something could finally be created. As they say, a great answer always starts with a good question.

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   Posted 12/2/2012 5:36 PM (GMT -6)   
Sure, if and when I can concentrate for longer than 30 mins. Right now, 2 minutes is hard :( :(.

I've realized there is no need for pressure sensors even. All you need is ability to adjust pressure remotely, coupled with patient feedback for a couple of days (when needed to burp, patient can change pressure until they can and record the pressure).

Endostim I think follows this theory and if it delivers on its promise, that is ideal.

Lets see how things work.

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   Posted 12/3/2012 3:37 AM (GMT -6)   
I am informed that Endostim is performing its first 3 operations in the UK in January 2013. I will be following this closely, so fingers crossed it works. smilewinkgrin

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   Posted 12/3/2012 1:15 PM (GMT -6)   
The Endostim looks very interesting. Who knows how long it will take til it is available in the USA.
GERD Moderator; Diagnosed GERD, no other medical conditions (this one is enough)

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Date Joined Apr 2012
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   Posted 12/3/2012 2:57 PM (GMT -6)   
The Endostim seems to "assume" (for lack of a better term) that the anatomy of the LES is OK, just that it needs to stay shut. Like to prevent TLESRs.

Like if someone had a warped door that lets lots of cold air in, putting a bigger lock on that door is not going to fix the issue which is that the structure of the door is bad.

Unless the Endostim device recruits some parts of the LES that are currently not used to prevent reflux, I think it would only work for patients with lots of TLESRs.

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Date Joined Oct 2012
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   Posted 12/3/2012 4:12 PM (GMT -6)   
drtinsac, valid point. There are a bunch of variables in Endostim.

If however a hypotensive LES can be shown to still be capable of HIGH pressures even if only occasionally (your structural validity assumption), Endostim would have a better chance of working for both TLESRs and hypotensive LESs.

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Date Joined Jul 2012
Total Posts : 190
   Posted 12/6/2012 5:09 PM (GMT -6)   
GC1pink, thanks for the post about endostims' first three implants in the UK.

Is there any further info on this, or a link?
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