Gastroesophageal reflux disease surgery: Difference between revisions
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An obsolete treatment is [[vagotomy]] ("highly selective vagotomy"), the surgical removal of [[vagus nerve]] branches that innervate the stomach lining. This treatment has been largely replaced by medication. | An obsolete treatment is [[vagotomy]] ("highly selective vagotomy"), the surgical removal of [[vagus nerve]] branches that innervate the stomach lining. This treatment has been largely replaced by medication. | ||
===Endoluminal fundoplication=== | |||
In June 2006 EndoGastric Solutions introduced [http://www.egseurope.eu EsophyX ELF] in the Europe Union as an alternative to surgical and pharmaceutical approaches for GERD treatment. EsophyX ELF is intended to deliver similar benefits as the time-proven laparoscopic fundoplication procedures, by reducing hiatal hernia, recreating the Angle of His, and creating a GastroEsophageal Valve (GEV). The key differences are that EsophyX ELF is an endoscopic non-invasive procedure that is performed transorally (through the mouth), does not require incisions, and does not dissect any part of the natural anatomy. | |||
Previous endoluminal treatments focused predominantly on the LES. However, failure to effectively treat reflux long-term with endoluminal therapies that focused only on the Lower Esophageal Sphincter (LES) combined with the fact that surgical approaches like Nissen fundoplication recreate the GEV and have excellent long-term efficacy, has led to an awareness that the GEV is probably the most powerful component of the Anti-Reflux Barrier. The device has been designed to deploy multiple tissue fasteners to create a robust and durable valve and is intended to restore the geometry of the GastroEsophageal Junction and recreate the natural, unidirectional valve mechanism necessary to prevent GERD. [http://www.endogastricsolutions.com/index.php?src=news&submenu=News&refno=19 EsophyX ELF has recently been cleared by the US FDA] and is now available in the U.S. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 23:02, 30 August 2012
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Gastroesophageal reflux disease Microchapters |
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Differentiating Gastroesophageal Reflux Disease from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Gastroesophageal reflux disease surgery On the Web |
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American Roentgen Ray Society Images of Gastroesophageal reflux disease surgery |
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Directions to Hospitals Treating Gastroesophageal reflux disease |
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Risk calculators and risk factors for Gastroesophageal reflux disease surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Surgical treatment
The standard surgical treatment, sometimes preferred over longtime use of medication, is the Nissen fundoplication. The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. The procedure is often done laparoscopically.[1]
An obsolete treatment is vagotomy ("highly selective vagotomy"), the surgical removal of vagus nerve branches that innervate the stomach lining. This treatment has been largely replaced by medication.
Endoluminal fundoplication
In June 2006 EndoGastric Solutions introduced EsophyX ELF in the Europe Union as an alternative to surgical and pharmaceutical approaches for GERD treatment. EsophyX ELF is intended to deliver similar benefits as the time-proven laparoscopic fundoplication procedures, by reducing hiatal hernia, recreating the Angle of His, and creating a GastroEsophageal Valve (GEV). The key differences are that EsophyX ELF is an endoscopic non-invasive procedure that is performed transorally (through the mouth), does not require incisions, and does not dissect any part of the natural anatomy.
Previous endoluminal treatments focused predominantly on the LES. However, failure to effectively treat reflux long-term with endoluminal therapies that focused only on the Lower Esophageal Sphincter (LES) combined with the fact that surgical approaches like Nissen fundoplication recreate the GEV and have excellent long-term efficacy, has led to an awareness that the GEV is probably the most powerful component of the Anti-Reflux Barrier. The device has been designed to deploy multiple tissue fasteners to create a robust and durable valve and is intended to restore the geometry of the GastroEsophageal Junction and recreate the natural, unidirectional valve mechanism necessary to prevent GERD. EsophyX ELF has recently been cleared by the US FDA and is now available in the U.S.