A tailored approach to reflux treatment
Treatment options for reflux depend on its severity. While mild reflux can be treated with lifestyle changes more severe reflux often accompanied by barrett’s esophagus can require intervention
Endoscopic treatment
For patients who are not responding to or not willing to take medications there are several endoscopic approaches available. These are generally regarded as less effective than surgery but also less invasive. The Transoral Incisionless Fundoplication (TIF) involves recreating the LES valve from within the stomach. The Stretta procedure applies a radiofrequency ablation catheter that causes the LES to scar down and increase the pressure of the LES valve. Applicability of these procedures can be determined on a case by case basis.
Minimally invasive surgery
Patients who do not respond well to lifestyle changes or medications or those who do not wish to continually require medications to control their symptoms, may consider undergoing a surgical procedure. Surgery is very effective in treating GERD. The most commonly performed operation for GERD is called a fundoplication (usually a Nissen fundoplication, named for the surgeon who first described this procedure in the late 1950’s). A fundoplication involves fixing your hiatal hernia, if present, and wrapping the top part of the stomach around the end of the esophagus to reinforce the lower esophageal sphincter, and this recreate the “one-way valve” that is meant to prevent acid reflux. This can be done by minimally invasive techniques using several small incisions, with the help of a surgical robot that allows for better cosmetic results, lower pain and hospital length of stay.
Robotic surgery
Anti-reflux surgery involves reinforcing the “valve” between the esophagus and the stomach with the help of a DaVinci Surgical Robot. Surgeons use small incisions (1/4 inch) to enter the abdomen through narrow tube-like instruments. Gas is used to temporarily expand the abdomen, giving the surgeon room to see and work. The entire operation is performed “inside” using narrow instruments that are passed through the trocars and controlled directly by the Surgeon or remotely through a DaVinci surgical Robot. Most patients go home on the same day.