An endoscopic sewing machine

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    Historically, there have been promising attempts at restoring the mucosal flap valve and augmenting the LES with endoscopic plication. The EndoCinch suturing device was the first such suturing device on the market for the endoscopic treatment of GERD,48 with the main goal of creating a full-thickness intussusception of the GEJ, resulting in an inverted gastroplication, or in other words, a gastrogastric plication. This plication technique is notable because it improved the Hill grade of the musculomucosal flap valve and reduced the relaxation rate of the LES.

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