Dear Doctor: The Latest in Incision-less Treatment for Chronic Heartburn/Reflux Disease?
Gastro-esophageal reflux affects millions of individuals in the United States. Surgery may be indicated if conservative lifestyle modification measures and/or medications are not working to control symptoms, patients do not desire to take daily medications for treatment of symptoms, or for certain complications of chronic reflux or side effects from medications.
In patients interested in pursuing surgery, certain diagnostics tests may be performed to determine which procedures may work best. These may include upper endoscopy, measurement of pH, manometry, and/or radiological studies.
Careful selection is important to maximize good patient outcomes. In certain cases, an incision-less procedure done through the mouth may offer substantial relief of symptoms and prevent the need for daily antacid medications.
There are a number of incision-less options. Several procedures mimic the standard surgical treatment of reflux disease by creating a partial wrap of the stomach around the esophagus (fundoplication) using a transoral or endoscopic approach. These include the transoral incisionless fundoplication (TIF) procedure and the MUSE (Medigus Ultrasonic Surgical Endostapler) procedure. A third procedure (Stretta) uses radiofrequency treatment to cause changes in muscles between the stomach and esophagus to decrease reflux symptoms. In the carefully selected patient, these procedures can offer lasting relief of both typical and atypical symptoms of reflux disease.
Dr. Peter Walker is a fellowship trained minimally invasive and robotic surgeon for the UT Health Science Center at Houston and provides patient care at UT Physicians at Cinco Ranch located at 23923 Cinco Ranch Blvd., Katy, TX 77494. To schedule an appointment, please call 713-486-5300.