Endoscopic suturing.

We describe the development of endoscopic sewing machines and ancillary equipment for knot tying and thread cutting. We outline the experimental studies in dogs, pigs and baboons prior to the first studies in man. We consider the early results achieved by groups in Europe and the U.S.A., and present the available evidence from peer-reviewed studies and data from numerous abstracts on the use of endoscopic suturing in man for treating gastro-oesophageal reflux. We consider the limitations of the available studies, and outline the requirements for improvements in flexible endoscopic suturing methods.