The radiofrequency energy procedure (aka Stretta procedure) is a minimally invasive, one-time endoluminal treatment for GERD that gently delivers precise radiofrequency waves to the lower esophageal sphincter (LES) using endoscopic tools.
The treatment produces vibrating water molecules and heat in the target tissue, which leads to tissue constriction and improved muscle wall thickness. The resulting scar tissue strengthens the muscle, or the heat kills the nerves that caused the malfunction. The changes decrease the frequency of transient lower esophageal sphincter relaxations, which are major mechanisms underlying GERD.
Similar to an endoscope, the flexible Stretta device is a thin tube, or catheter, with a balloon at the end. With the patient conscious but under sedation, the catheter is guided through the endoscope which is placed in the esophagus just above the stomach. There the balloon is inflated, exposing four sharp probes on the outside of the balloon. Once the balloon is properly situated, RF energy waves are delivered to the muscles of the LES in one minute intervals for a total of 14 minutes. The LES area treated is a cuff about one inch in length.
The total procedure time is approximately 30-45 minutes. After the procedure the treated sphincter will become stronger and will function normally as a barrier to prevent acid from refluxing into the esophagus. Tightening the LES keeps stomach acid from splashing up into the esophagus.
The Stretta procedure has been demonstrated to increase lower esophageal sphincter pressure, decrease esophageal acid exposure time, decrease the need for acid blocking drugs, and controlling esophagitis. Significant improvements in physical and mental quality-of-life scores of GERD patients have been noted after the Stretta procedure.
The procedure can be performed as outpatient. Patients typically return to normal activities the following day. Studies has shown that one year after undergoing the Stretta procedure, nearly two-thirds of the patients were able to stop taking all of their acid-blocking medicines. Overall, the patients reported feeling significantly better six months after treatment -- and even better at the 12-month mark. A recent study reported that 81% of patients remained symptom-free for up to 3 years following the Stretta procedure. Individual results may vary and the long term benefits are uncertain.
Current data shows that when used by a trained physician, the Stretta procedure is pretty much as safe as a routine endoscopy procedure (also called esophagogastroduodenoscopy), though it is not without risk. There is potential for serious complications: there have been reports of perforation, hemorrhage, and even death.
GERD Surgery - Radiofrequency Energy Procedure - References
By Mortin - Copyright 2010
Last modification 05/02/2010