acid reflux heartburn GERD logo

GERD Surgery - Endoscopic Suturing

Several treatments employing endoscopy are being used or tested for increasing the strength of the lower esophageal sphincter to prevent reflux and other gerd-related complications. Many of these techniques have studies underway but have not had ample long-term follow-up to evaluate their effectiveness and possible complications.

Transoral Flexible Endoscopic Suturing

Transoral flexible endoscopic suturing (also called Bard's procedure, or the Bard EndoCinch Suturing System) uses a tiny device at the end of the endoscope that works like a mini sewing machine. It sutures stitches near the lower esophageal sphincter, which tighten the valve and increase pressure to prevent reflux.

The endoscope is inserted down the patient's throat and sutures are stitched in two locations near the lower esophageal sphincter. The sutures are tied together to
create a pleat, which are then tied to tighten the valve and increase pressure.

The endoscopic suturing procedure has many advantages over the alternative treatments for GERD.

  • the procedure does not require an incision and is performed on an outpatient basis
  • patients may experience relief from symptoms in days, not weeks
  • most patients resume normal activities the day following the procedure
  • typically, only mild sedation is required
  • reduces reliance on acid-controlling medication
  • clinical studies show reduced regurgitation and significant improvement in patient symptoms

The most commonly reported side effects from the clinical trials included nausea, vomiting and sore throat.

Endoscopic suturing may be a promising alternative for the treatment of persons with
severe GERD. The potential benefits are a reduced use of medications and an avoidance
of major surgery. Appropriate patient selection is important. Patients may require retreatment after several years or as a result of procedural difficulties with the initial suturing. Further studies are needed to establish the long-term effectiveness of this technology, and to determine the costs, safety and patient preferences for endoscopic suturing in comparison with other therapies.

GERD Surgery - Endoscopic Suturing: References

By Mortin - Copyright 2009
Last modification 30/12/2009