Technologies/Companies to watch ...

Wow, clinical trials before the end of this year in Europe!!??? YES PLEASE!!!

Could you pass me the direct link to that article? I didnt know they would start with clinical trials in Europe!

Ive known about them for some time and I think this could be the 100% rock solid solution for all of us!

Thanks!

I already knew about the azcentral article. I knew about the ones they were doing that year , 2010, I thought you ment 2011, thats why I was suprised!

Anyways, lets hope we know something soon about it being available to everyone! Ill do some reasearch to see if I can find someone thats part of the trials.

That article came out in November and those are the time-frames they are quoting from that time .. I wonder if things fizzled out or otherwise we would've heard more about it by now ...

I wonder how this device would operate though .. if the current device is anything like a pacemaker then it'll probably sit outside and be connected to the LES somehow from some incision or something? Seems kind of impractical for the long run though ..

AZCentral Article said...
Arizona State University engineering professor Bruce Towe helped create the technology, which includes a microchip that is so tiny that it can fit through a syringe.

For now, EndoStim is using a pacemakerlike device that is being tested on patients in India and Chile. It is similar to a pacemaker used by cardiac patients. The company is working with engineers in Seattle and consultants in Uruguay to build a smaller, implantable device that can be inserted in the muscle via a long tube.

What I understand is that for now they are using a pacemakerlike device but what they really want to achieve is a small device that can be implanted INTO the LES. Sounds good to me, I mean...you are making the LES work as it should with a little help. No stomach anatomy modification that you get with the Nissen and I bet the device can be removed if necessary

I just hope this device ends up being a total succes! Hope!

Well...I really dont know, ill keep searching for information but maybe the people that underwent the trials might have had to sign a contract or something that doesnt allow them to spread information about it on the net, Im just guessing!

This sound promising. I wonder though how it will work. The article says "The device works by electrically stimulating nerves that control the muscle, telling the muscle to contract and block acid discharges from the stomach."

But the muscle also needs to retract every couple of minutes in order to allow air and food or salaiva in and out of the stomach.

I feel like I want all these new procedures to be done to me at once. A biological graft for the hernia, Esophyx and Linx and to top it off this device as well. Just so long as I don't have to do the Nissen.

Thanks Gilad .. this indeed is quite interesting ... this is exactly the type of fundamental solution to these problems (at the cellular level) .. that the medical research should be working on ..

Endostim trials...
http://clinicaltrials.gov/ct2/show/NCT01578642
http://clinicaltrials.gov/ct2/show/NCT01574339

This is essentially the way in which Endostim is presumed to work, automatically, in fact. How, if it is indeed the case, it does this is presently unknown.

My understanding is that the LES is a circular band of muscle that is continuously being stimulated to contract. During swallowing, gastric belching, vomiting and sometimes spontaneously the stimulation is inhibited and it relaxes. It is these spontaneous inhibitions that allow material to reflux backward (because gastric pressure is greater than the pressure of the distal esophageal lumen).

One would think that in order for a device like Endostim to work, it would have to stimulate contraction at precisely the times of the spontaneous relaxations; otherwise, it would interfere with the required relaxation during swallowing. However, when it was first studied in dogs, it turned out that stimulation did not impact the relaxation during swallowing. At the same time, it appeared to prevent reflux, thus suggesting that it is somehow automatically inhibiting the inhibitions of the spontaneous relaxations (although as far as I can tell, and strangely from my opinion, this hasn’t been formally measured).

It’s not clear what the role is for being able to alter the frequency/amplitude of the stimulation. In the published studies, they tried only two different paradigms and found that either one worked. Only one patient experienced discomfort, which disappeared when the frequency/amplitude was adjusted.

Endostim definitely increases the baseline pressure of the LES, but somehow it doesn't appear to stop the natural relaxations of the sphincter during vomiting or gastric belching.

One explanation may be the relaxation of the sphincter during swallowing, belching, vomiting is somehow physiologically different from relaxations during the spontaneous transient relaxations.

The LES naturally relaxes for swallowing, gastric belching and vomiting. Not having it relax is a disease called achalasia. I don't think there is any qualitative difference between that relaxation and the relaxation in spontaneous, transient relaxations. However, the trigger may involve a different mechanism. For example, it is probably the case that transient relaxations are triggered by the brain (via the vagus) whereas the others are local, but I'm not sure this is known for sure. If so, one way Endostim might be working is having the LES ignore the brain. We might have an answer to this question when current clinical trials are finished and the results published.

All the info comes from what I could find online, some of which is referenced elsewhere on this site. I think there have been five published studies, including one on dogs. In addition, the patent had been posted elsewhere on this site. Finally, I emailed them directly, though they haven't fully answered all my questions.