Gastroesophageal reflux disease (GERD) is a common condition that affects millions of people worldwide. It occurs when stomach acid backs up into the esophagus, causing symptoms like heartburn, chest pain, regurgitation, and difficulty swallowing. While lifestyle changes and medication can help manage mild to moderate GERD symptoms, some patients require more advanced treatment options. In recent years, new devices have been developed to help treat chronic GERD when medications are no longer effective. Here's an overview of some common GERD treatment devices available today.
Endoscopic Radiofrequency Ablation
For patients with moderate to severe GERD that does not adequately respond to medications, endoscopic radiofrequency ablation (RFA) can provide long-term relief. This procedure uses radiofrequency energy delivered through an endoscope to scar and tighten the lower esophageal sphincter (LES). The LES is the muscular valve between the esophagus and stomach that normally closes to prevent regurgitation of acid. With RFA, the damaged sphincter can be strengthened to reduce reflux episodes.
Multiple studies have found RFA to be highly effective at controlling GERD symptoms for at least 5 years after treatment. A single 30-45 minute procedure is usually done on an outpatient basis. Risks are generally minor and may include a sore throat or difficulty swallowing that resolves within a few days. Many insurance plans cover RFA as it has been shown to eliminate the ongoing need for acid-reducing medications in 75-80% of patients.
Stretta Procedure
Like RFA, the Stretta procedure aims to strengthen the LES through the use of radiofrequency energy delivered through a catheter. However, instead of scarring the tissue, it triggers the growth of new collagen and muscle fibers. During the minimally invasive outpatient procedure, four balloon-tipped catheters are inserted through the mouth and positioned across the LES. Radiofrequency energy is then delivered in a series of pulses to stimulate tissue repair and remodeling over time.
Multiple randomized controlled studies have found the Stretta procedure to significantly reduce symptoms of heartburn, regurgitation, and medication usage for at least 5 years post-treatment. Adverse effects are typically mild and temporary, including pain or difficulty swallowing after the procedure. The Stretta may be an option for patients who cannot or do not want to undergo surgical options like fundoplication.
LINX Reflux Management System
For patients with severe Gastroesophageal Reflux Disease Treatment Devices who require more permanent control of reflux, surgical fundoplication has been the gold standard. However, it carries risks of side effects like gas bloat syndrome and inability to belch or vomit. The LINX Reflux Management System offers an innovative surgical option designed to mimic the effects of fundoplication with fewer side effects.
During a laparoscopic procedure, a flexible band of magnetic beads is placed around the LES. Rather than tightening the tissue, it reinforces the existing sphincter to prevent acid from flowing back up. Multiple clinical studies have shown LINX to significantly reduce heartburn, acid reflux events and use of medications, with over 90% of patients able to stop all GERD drugs. Adverse events were minor, and patient satisfaction rated as high. Five-year data also confirmed LINX remains highly effective without long-term complications. The LINX System offers an exciting surgical solution for those seeking a permanent way to control reflux without major lifestyle changes.
Medigus Ultrasonic Surgical Endostapler (USE)
For those seeking a classic surgical option like fundoplication without associated side effects, the Medigus Ultrasonic Surgical Endostapler (USE) offers a novel laparoscopic approach. The USE device incorporates real-time ultrasound imaging to precisely guide placement of surgical staples that reinforce the folded fundoplication. Controlled by the surgeon, it allows creation of a loose or tight "floppy" Nissen fundoplication tailored to each patient's needs.
Early clinical studies show the USE technique results in significantly reduced symptoms and improved quality of life scores compared to standard fundoplication at 6 months follow up. Advantages include elimination of gas bloat in most patients by creating a looser wrap, along with fewer incidents of inability to belch or vomit. The precise ultrasound-guided stapling also leads to shorter learning curves for surgeons. Larger trials are ongoing but initial results suggest the USE may offer an improved surgical option for carefully selected GERD patients.
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