for people ages 18-65 (full criteria)
at UC Irvine
study started
estimated completion:



Hernia Reduction Prior to Scheduled TIF Completion using EsophyX ZR transoral device

Official Title

Hernia Reduction Prior to Scheduled TIF Completion- The HEURISTIC Study


Evaluation of the relative merits, safety and effectiveness of the EsophyX ZR transoral device in performing the standardized TIF 2.0 procedure preceded by laparoscopic Hiatal Hernia repair in PPI-prescribed patients with persistent "troublesome symptoms" per the Montreal consensus definition


Fundoplication transoral incisionless EsophyX ZR transoral device TIF using EsophyX ZR transoral device


You can join if…

Open to people ages 18-65

  1. Age 18-65 years
  2. Dependent upon daily PPIs for > 6 months. Daily use is defined as a double dose, or full dose or half dose taken daily for more than 80% of the total number of days during the proceeding evaluation period
  3. Troublesome symptoms, specifically heartburn or regurgitation, while on optimized dose of PPI's Troublesome heartburn or regurgitation symptoms are those which occur a minimum of 2 days a week and are mild to severe in severity
  4. Abnormal ambulatory (Bravo) pH study after off PPI therapy for 7 days, i.e. > 5.3% of the time with pH < 4 in a 48-hour monitoring period
  5. Normal or near normal esophageal motility (by Upper GI/ esophagram or manometry as required)
  6. Pre-enrollment Hiatal Hernia (axial height and transverse dimension) from > 2 cm up to 4 cm inclusive.
  7. Patient willing to cooperate with post-operative dietary recommendations and assessment tests at the requisite follow-up visits
  8. Signed informed consent

You CAN'T join if...

  1. BMI > 35 2. Hiatal hernia ≤ 2 and > 4 cm 3. Esophagitis Los Angeles grade C or D 4.

Esophageal ulcer 5. Esophageal stricture 6. Long-segment Barretts esophagus (Prague: C > 1,M > 3) 7. Esophageal motility disorder 8. Pregnancy or plans for pregnancy in the next 12 months (in females) 9. Immunosuppression 10. ASA > 2 11. Portal hypertension and/or varices 12. History of previous resective gastric or esophageal surgery, cervical spine fusion,Zenker's diverticulum, esophageal epiphrenic diverticulum, achalasia, scleroderma or dermatomyositis, eosinophilic esophagitis, or cirrhosis 13. Active gastro-duodenal ulcer disease 14. Gastric outlet obstruction or stenosis 15. Severe gastroparesis or delayed gastric emptying confirmed by solid-phase gastric emptying study if patient complains of postprandial satiety during assessment 16. Coagulation disorders 17. Atypical symptoms including gas bloat and dysphagia. 18. Any other presenting condition that in the opinion of the investigator would not make participation in this study in the patient's best interest.

Post Enrollment Exclusion -

  1. Inability to repair Hiatal hernia with at least 2cm of intra-abdominal esophagus length.


  • University of California, Irvine Medical Center not yet accepting patients
    Orange California 92868 United States
  • South Global Medical Center not yet accepting patients
    Santa Ana California 92704 United States
  • Los Robles Hospital not yet accepting patients
    Thousand Oaks California 91360 United States


not yet accepting patients
Start Date
Completion Date
EndoGastric Solutions
Study Type
Last Updated
September 9, 2017