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New Treatment for GERD Tested

Experimental Surgery Could Prevent Acid Reflux Without Medication

WebMD Health News

Oct. 28, 2002 -- An experimental surgical procedure is being tested as an alternative treatment to medications commonly used to relieve acid reflux.

The procedure, called The Gatekeeper Reflux Repair System, involves placing four tiny prostheses into the walls of the esophagus to prevent acid from moving up from the stomach. The devices are made of a material similar to that used in contact lenses.

The Gatekeeper system is the latest surgical technique being tested to treat gastroesophageal reflux disease (GERD), which affects at least 60 million Americans. About one-third of them are on regular medication.

The devices are implanted during a one-hour surgery and are slightly thinner than a strand of spaghetti. Within 24 hours, as they get wet from drinking water, they expand to the size of a standard No. 2 pencil and "act as a cushion on the esophageal walls," says Kenneth Binmoeller, MD, of California Pacific Medical Center, one of the three sites in the U.S. conducting the experimental procedure.

This bulks up the lining of the esophagus enough to block the backflow of stomach acids that irritate the esophagus. But food can still travel through the esophagus and into the stomach.

"The procedure is quite simple and appears to have no complications as long as the devices are inserted correctly," says Binmoeller. "It's designed for people who have mild GERD and are getting relief from medications but would like to avoid the inconvenience of taking medications."

If it proves effective, it could bring relief to many of the 21 million Americans taking medications for GERD.

If not inserted precisely, though, the devices could dislodge, offering no relief but little danger to patients.

After two years of testing the devices on pigs, Binmoeller has implanted them in one patient, who found little relief. At other centers, though, he says most patients report the Gatekeeper system improves their acid reflux. He is currently recruiting about 15 adult patients for the trial.

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