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June 17, 2002


Out-Patient Procedure for GERD Uses Radio Frequency Energy to Produce Dramatic Results

Emory gastrointestinal 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 necessary.

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.

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