https://www.nyreflux.com/barrett-cancer daily 0.75 2020-04-25 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e91e0c59db2e4646965b176/1587732738615/stomach.png Barrett/Cancer Cancers and pre-cancerous lesions of the stomach and the esophagus can be challenging to manage. Our multidisciplinary team approach involves multiple professionals to deliver individualized approach to such problems. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e98be55fce5d71ac7d6ca7f/1587853480866/Screen+Shot+2020-04-16+at+4.14.53+PM.png Barrett/Cancer Early cancers of the esophagus (a condition called barrett’s esophagus) when discovered early can be treated with minimally invasive procedures and surveillance. Often ablation with a heat catheter is enough to prevent further progression to full blown cancer. https://www.nyreflux.com/heartburn-treatments daily 0.75 2020-04-25 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8df7483f8c900ea8dc075a/1587853145625/TIFF.jpg Heartburn treatments - 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. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e908ff01e8d0c614e4a3586/1587853182423/Picture1.jpg Heartburn treatments - 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. https://www.nyreflux.com/gastroparesis daily 0.75 2020-04-30 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e91d9b71680cc01e2d56294/1586616874728/gastroparesis.jpg Gastroparesis https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e91da76ea9b38302e3674af/1588290425605/POP.jpg Gastroparesis - G-POEM G-POEM involves releasing the valve that regulates the entry of the food from the stomach to the duodenum (pylorus). This is done endoscopically without any surgical incision and discharge is usually the same day of the operation. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e91db42d3ef8947b33d4cb2/1588290436143/Diagrammatic-representation-of-the-laparoscopic-placement-technique-showing-trocar.png Gastroparesis - Gastric stimulator The gastric neurostimulator is a programmable device that generates mild electrical pulses for gastric electrical stimulation to treat chronic, intractable nausea and vomiting due to gastroparesis. This small, battery-powered gastric neurostimulator is implanted beneath the skin in the lower abdominal region. The neurostimulator generates controlled electrical pulses delivered by leads to the antrum portion of the stomach muscle wall. After implant, the clinician optimizes therapy for the patient with a clinician programmer. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e91df2e39bf386e54465fb6/1588290448383/Picture1.jpg Gastroparesis - Minimally invasive options If previous options or medications do not relieve your symptoms several other minimally invasive robotic options are available to improve your symptoms. https://www.nyreflux.com/swallow-disorders daily 0.75 2020-04-25 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e98b916b6bf55381941e5d3/1587733323324/Screen+Shot+2020-04-16+at+3.49.23+PM.png Swallow disorders Do you experience difficulty swallowing or recurrent episodes of chest pain? You could be suffering from esophageal spasms or nutcracker esophagus. https://www.nyreflux.com/home daily 1.0 2020-05-01 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8d10892583af3224c56264/1587437509611/Screen+Shot+2020-04-07+at+7.44.38+PM.png Home - State of the art minimally invasive treatments Treatment options are tailored to patient needs and range from medications, to endoscopic (incisionless) approaches to robotic minimally invasive surgery. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8d053203d2fa0527be3634/1587437389211/Northwell-8782.jpg Home - Expedited medical consultation Appointments can be arranged in Manhattan (Uptown, Downtown) within a week in most cases with a board certified physician which specializes in diseases of the stomach. Telehealth consultations are available. Conditions commonly treated include reflux (heartburn), achalasia, nutcracker esophagus, esophageal spasm, ineffective esophageal contractions, GIST tumors, barrett’s esophagus, stomach cancer and weight loss surgery. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8d08b81630285837984bb9/1587437465327/IMG_0309+%281%29.jpg Home - Integrated diagnostic evaluation Diagnostic tests can be necessary to further investigate the nature of the symptoms. Most times an upper endoscopy, with gastric acid testing and swallow testing is the test of choice. All these tests can be performed by the same physician, on the same session. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8e55417bc5096dca81dec3/1587437545372/Filicori+Filippo+MD+2017+3x5+%281%29.jpg Home - Filippo Filicori, MD Dr. Filicori is a Board Certified Minimally Invasive Surgeon who specializes in Robotic, Laparoscopic and Endoscopic treatment of Disorders of the Upper Gastrointestinal tract. He graduated Medical School Summa cum Laude from the University of Bologna (Italy) before completing a year of post-doctoral research and a General Surgery residency at Weill Cornell Medical College and Memorial Sloan Kettering Cancer Center in New York, NY. He then obtained further fellowship training in Minimally Invasive Surgery at The Oregon Clinic in Portland, OR before joining Lenox Hill Hospital as an Assistant Professor of Surgery.. Dr. Filicori specializes in the treatment of disorders of the Upper Gastrointestinal tract such as Reflux (GERD), Stomach Cancer, Achalasia, Esophageal Spastic Disorders and Gastroparesis as well as Weight Loss Surgery. His primary research interests are Robotic Surgery as well as minimally invasive outcomes for the treatment of reflux, obesity and dismotility disorders. On these topics he has authored more than 20 publications on Peer reviewed International Journals, 30 presentations at international meetings and 2 book chapters. He is also the recipient of 2 international grants and is currently involved in 4 active clinical trials. Dr. Filicori is a member if the American College of Surgeons (ACS), the American Society for Metabolic and Bariatric Surgery (ASMBS), the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the Society for Surgery of the Alimentary Tract (SSAT) and the European Association of Endoscopic Surgery (EAES). https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5eab6013b694234cc89ca486/1588289565829/Screen+Shot+2020-04-30+at+7.30.47+PM.png Home https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5eab5ff5fdf2d726c17e4a22/1588289539647/Screen+Shot+2020-04-30+at+7.29.47+PM.png Home https://www.nyreflux.com/what-causes-heartburn-gerd daily 0.75 2020-04-30 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8d36f20340080865c09e6e/1587733150159/stomach.png What causes heartburn (GERD)? - What causes heartburn? When you eat, food travels from your mouth to your stomach through a tube called the esophagus. At the lower end of the esophagus is a small ring of muscle called the lower esophageal sphincter (LES). The LES acts like a one-way valve, allowing food to pass through into the stomach. Normally, the LES closes immediately after swallowing to prevent back-up of stomach juices, which have a high acid content, into the esophagus. GERD occurs when the LES does not function properly allowing acid to flow back and burn the lower esophagus. This irritates and inflames the esophagus, causing heartburn and eventually may damage the esophagus. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e908caa1fc27279d6478089/1586531506493/Screen+Shot+2020-04-09+at+11.03.18+PM.png What causes heartburn (GERD)? https://www.nyreflux.com/achalasia daily 0.75 2020-04-25 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8e518513ecb20c0e0d4cfe/1586385291716/Achalasia.png Achalasia - What is Achalasia. Achalasia is a rare disease of the muscle of the lower esophageal body and the lower esophageal sphincter that prevents relaxation of the sphincter and an absence of contractions, or peristalsis, of the esophagus. The cause of achalasia is unknown; however, there is degeneration of the esophageal muscles and, more importantly, the nerves that control the muscles. Achalasia usually manifests itself with difficulty swallowing, chest pain, regurgitation or throwing up, Luckily multiple treatment options are available for this disorder. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8e51c2f078bb5a2e255a1b/1587853271287/Poem.png Achalasia - POEM (Per Oral Endoscopic Myotomy) POEM is a minimally invasive procedure which releases the valve at the end of your esophagus relieving your difficulty to swallow. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e8e51ded758107529760cbb/1587853313849/Heller.png Achalasia - Heller myotomy Heller myotomy is a minimally invasive procedure that releases the lower esophageal valve and prevents acid reflux from happening. This is usually performed robotically with 4 small incisions with the help of the surgical robot. https://www.nyreflux.com/general-4-1 daily 0.75 2020-04-30 https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e91332a39bf386e5436eb76/1587853532064/IMG_0244.jpg Testing - Endoscopy The test is generally done under conscious sedation with a camera that allows to visualize the esophagus and the stomach. Biopsies (tissue samples) can be taken at the time of the test. You can return to your regular activities in a couple hours. https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e9134337c32661815af4a98/1587853564788/Medtronic+-+Bravo+Capsule+Placement+Illustration+-+WEB+Format.png Testing - pH test (Bravo capsule) This test allows us to determine the acid output of the stomach and determine if there is any reflux into the esophagus. This test is needed before any procedure takes place. It is performed by leaving a small capsule at the end of your esophagus. This capsule transmits wirelessly to a recorder which you carry around like a cell phone and it passes through after 2 days, https://static1.squarespace.com/static/5e8c99080d822c25bdcace43/t/5e9134b7d045b4472924da80/1587853716547/Medtronic+-+ManoScan+Mobile+Workstation+-+PRINT+Format.jpg Testing - Manometry This test tells whether your esophagus works properly at pushing food and liquid through. The test lasts for 5 minutes and it involves putting a small catheter in your esophagus which measures the pressures that are generated with swallowing. https://www.nyreflux.com/contact daily 0.75 2020-05-01