Non-invasive Treatment for GERD Adopted at Boston Medical Center

December 1, 2009

A new treatment has been developed for GERD that does not require an incision into the skin, an option that may shorten recovery time and reduce possible side affects.

Surgeons at Boston Medical Center (BMC) have adopted a new technique for treating GERD and acid reflux disease that does not require an incision into the skin.

The new treatment, EsophyX Transoral Incisionless Fundaplication (TIF), allows surgeons to pass surgical instruments and an endoscope through a patient’s mouth to tighten or repair the weakened valve in the esophagus that causes symptoms of GERD or acid reflux. This method of correcting the valve is less invasive than the treatments traditionally used for GERD, according to the researchers.

Correction of the damaged valve is necessary to prevent symptoms of GERD, the researchers add, as well as other problems that can be related, such as esophageal ulcers and Barrett’s esophagus, which can lead to esophageal cancer in a small percentage of patients. However, the researchers add that less than one percent of GERD patients currently choose surgical therapy, because it is invasive and “may be associated with side effects like gas bloat and difficulty swallowing.”

“Compared to laparoscopic or traditional surgery, patients treated via the endoscope have required less anesthesia and experienced less complication rates, shorter hospital stays and faster recovery, reduced patient discomfort, and no need for incisions,” said Miguel Burch, MD, co-director of Esophageal and Acid Reflux Disorders, Center for Digestive Disorders at BMC. “Patients are typically able to return home and to normal activities the day following the procedure.”

“While over-the-counter medications may alleviate the symptoms, by decreasing production of stomach acid, they don’t solve the anatomical problem and reflux (without acid) can still continue causing injury but without symptoms to warn the patient,” said Hiran Fernando, MD, a cardiothoracic surgeon and director of minimally invasive thoracic surgery at BMC who performs the procedure with Burch. “For patients who are dissatisfied with pharmaceutical therapies and are concerned about the long-term effects of over-the counter medications, this procedure may be the answer.”