Procedure for GERD Uses Radio Frequency Energy to Produce Dramatic
surgeons are offering patients a new and minimally invasive option for
the treatment of gastroesophageal reflux disease (GERD). The endoscopic
procedure, called the Stretta System, uses a specially designed catheter
to deliver precisely controlled radio frequency to the affected area.
When food is swallowed, it
travels down the esophagus and reaches the stomach through a muscular
ring called the lower esophageal sphincter (LES). The LES opens to allow
the food to enter the stomach and then closes back up to form a barrier
to prevent the food from re-entering the esophagus. The food is then
broken down by stomach acids before moving on into the intestines.
Reflux is experienced when
such things as spicy foods, over-eating, smoking, drinking alcohol or
pressure on the stomach weaken the LES barrier, allowing the contents
of the stomach to flow back into the esophagus. Irritation from the
stomach acids causes an uncomfortable burning sensation, or inflammation
of the esophagus, which can usually be controlled by the combination
of lifestyle changes and over-the-counter antacids. However, when neither
diet nor medication are successful, a surgical procedure may become
The Stretta procedure is
performed on an outpatient basis, under twilight sedation. A special
tube is inserted through the mouth and into the esophagus to the area
of the LES and a balloon is inflated. Needle electrodes are deployed
into the tissue from a basket surrounding the balloon, and radio frequency
energy is directed through the electrodes, creating thermal lesions.
Once those lesions heal, the barrier function of the LES is improved.
The result is a dramatic reduction in GERD symptoms, and a majority
of patients who no longer require medication. Patients can return to
all of their usual activities, including work, the day after the procedure.
"Patients now have an option
other than surgery when medications don't completely control their heartburn
or when they want to be free of daily medications," said C. Daniel Smith,
M.D., FACS, Associate Professor of Surgery at Emory University School
of Medicine and Chief of General and Gastrointestinal Surgery at Emory
University Hospital. "When patients have serious symptoms that are not
improved by medication, the Stretta procedure is not only very safe,
but also very effective. Eighty percent of patients have a significant
decrease in the amount of acid in their esophagus after the procedure."
The Stretta System was developed
by Curon Medical, Inc. and received FDA approval in April 2000 for the
treatment of GERD.