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Treating Heartburn With Surgery

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Types of Surgery for GERD continued...

In most cases, the top part of the stomach is wrapped all the way around the esophagus. People with other problems in the esophagus besides reflux may undergo a modified surgery with only a partial wrap.

Other types of surgery can also be done with a laparoscope. For example, a ring of titanium beads can be placed around the outside of the lower esophagus. It strengthens the valve between the esophagus and stomach while still allowing food and liquids to pass through. 

Laparoscopic surgery requires a shorter recovery time with less pain than open surgery. Plus it leaves no large scar. When performed by an experienced surgeon, laparoscopic surgery works at least as well as traditional open surgery. In some cases, symptoms may return or develop and additional surgery may be needed.

Minimally Invasive (Endoscopic) Procedure for GERD

By using endoscopy, doctors can also treat GERD in the esophagus without an incision in the abdomen. Endoscopy for GERD uses a flexible tube that is placed through the mouth and into the esophagus and stomach. The tube contains a light and camera to visualize the inside of the body. Through the endoscope, doctors can also take tissue samples and perform procedures using other tools. 

Minimally invasive endoscopic treatments for GERD involve:

Endoscopic procedure. A doctor operates with a limited set of small surgical tools at the tip of an endoscope. Using a procedure called the Esophyx system, the doctor tightly binds the end of the esophagus to the top of the stomach. With the EndoCinch system, stitches are placed in the lower esophagus to form pleats that strengthen the area.

Radiofrequency treatment. This is also known as the Stretta procedure. During endoscopy, high-energy waves are directed into the wall of the lower esophagus. The esophagus responds by producing small amounts of scar tissue. In most people, this reduces heartburn and other acid reflux symptoms. More than one radiofrequency treatment may be required to achieve a good result.

Endoscopic procedures are usually effective but are not as good as surgery at treating acid reflux, generally speaking. However, they offer the significant advantages of not requiring incisions, general anesthesia, or a hospital stay.

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