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  • #16
    Implant Design Considerations

    Originally posted by shayward
    Why doesn't the wrapping the fundus around the eosophagus have the same negative effects that an artificial device would?

    Surely just as much pressure needs to be applied for the Nissen Fundo operation to have any positive effect?
    The geometry and elasticity of any implant, which applies continuous pressure on tissue, is critical to its safety and efficacy. Any contact areas, which produce high stress (pressure) on the underlying tissues can cause damage. i.e. there have been cases of early-design vascular stents slowly migrating toward the outside of vessels due to excessive stress on the interior vessel wall. Areas of high stress result in localized tissue damage.

    The fundoplication procedure possesses the advantage of wrapping a large thick compliant tissue around the esophagus, which is smooth and will, itself, remodel (change geometry) due to localized stress. Furthermore, the properties of the tissue wrapped around the LES do not change over time. Most implanted visoelastic polymers will degrade over the course of implantation (20+ years); this will result in a loss of implant compliance and potentially the build-up of scar tissue.

    Not to say that it can't be done....but, it is not simple.

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    • #17
      hi

      hi

      Why are not biomechanical engineers, docotrs and biophysics majors not working on gerd. i hope they will come up with something. its very frustrating esp. when we know what is wrong.

      prego

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