Stretta Procedure
For patients interested in a non-surgical treatment option, radiofrequency (RF) energy delivery via endoscopy, commonly called Stretta, can provide symptom relief. During the Stretta procedure, a catheter equipped with electrodes is used to deliver controlled RF energy to the lower esophageal sphincter and stomach cardia. This targets the nerve pathways believed to be involved in triggering reflux and aims to alter the biomechanical function of the lower esophageal sphincter through controlled scarring and thickening.
While Stretta does not offer as durable or consistent results as LINX or fundoplication surgery, short and intermediate term studies have found it provides satisfactory symptom control for approximately 50-60% of patients. Potential advantages over other endoscopic therapies include its ability to treat both acid and non-acid reflux in one outpatient session, with a faster recovery time compared to LINX or surgery. However, like other endoscopic therapies, additional treatments may be needed over time.
Endoscopic antireflux procedures like LINX and Stretta provide minimally invasive surgical and non-surgical options for adults whose reflux is not well controlled by medications alone. Both avoid the costs and risks of open surgery while offering the potential for sustained relief of heartburn symptoms.
Endoscopic Suturing Systems
For patients requiring surgical treatment of Gastroesophageal Reflux Disease Treatment Devices, but who want to avoid the risks of an open approach, novel endoscopic suturing devices are expanding treatment options. These systems allow physicians to perform partial or complete fundoplication procedures through the mouth using specialized endoscopic suturing devices to replicate the effects of laparoscopic or open fundoplication.
The EsophyX device from Endogastric Solutions was one of the first commercially available endoscopic suturing systems approved for GERD. It utilizes a flexible endoscope to place full-thickness sutures in a “pursestring” fashion to create a reinforced lower esophageal sphincter. Long-term studies show it controls reflux as effectively as laparoscopic Nissen fundoplication with less post-operative pain and quicker recovery.
Other entrants to this field include the Plicator by Medtronic and OverStitch by Apollo Endosurgery. While the techniques differ, all aim to recreate the antireflux barrier of fundoplication surgery using advanced endoscopic suturing to gather and secure the gastric fundus around the lower esophagus. For suitable patients, these emerging technologies expand surgical options into a purely endoscopic approach with the potential for reduced risks compared to laparoscopy or laparotomy.
Ambulatory Reflux Monitoring Devices
Novel ambulatory reflux monitoring devices are also enhancing the evaluation and management of GERD patients. Traditional pH probes require an invasive nasal or esophageal catheter placement and only measure acid, not non-acid reflux. New wireless Bravo and Mimic capsules instead use radio telemetry to transmit pH and pressure data from a capsule placed in the esophagus during an endoscopy.
The Bravo and Mimic systems offer major advantages over conventional pH monitoring. They allow ambulatory, catheter-free reflux monitoring for up to 96 hours to better assess nocturnal, post-prandial and silent reflux patterns. The Bravo capsule also directly measures both acid and weakly acidic reflux episodes. This enhanced diagnostic accuracy helps identify truly refractory GERD patients who may benefit from advanced endoscopic or surgical anti-reflux therapies like Stretta, LINX or fundoplication.
Impedance-pH monitoring takes diagnostic capabilities even further by combining multichannel intraluminal impedance with conventional pH sensing. The Sandhill Scientific ZHP device simultaneously measures pH, impedance and pressure changes along the esophagus. This enables direct visualization and detailed characterization of all types of refluxate, regardless of acidity. Impedance-pH monitoring has emerged as the new gold standard diagnostic test for evaluating difficult-to-manage GERD and its related complications.
By quantifying both acid and non-acid reflux patterns over prolonged monitoring periods, novel ambulatory reflux devices improve our ability to differentiate between truly pathological reflux and normal physiological variants. This enriched diagnostic information aids clinical decision making regarding optimal medical versus surgical management strategies based on each individual patient’s unique reflux profile.
Explore more information on this topic, Please visit -
Explore more trending article related this topic -
https://captionssky.com/adhesive-tapes-evolution-and-applications/
https://captionssky.com/biologics-a-transformative-field-of-biotechnology/
Comments
0 comment