7RECENT Advances in Endoscopic Treatments for Gastroesophageal Reflux Disease

Abstract

There is a growing interest in minimally invasive approaches to the management of gastroesophageal reflux disease (GERD), including endoscopic GERD therapy. This review evaluates available endoscopic therapeutic options utilized in GERD management. Application of radiofrequency energy at the esophagogastric junction (EGJ) reduces reflux symptoms, but esophageal acid exposure does not necessarily normalize, and esophageal sensation is compromised. Two approaches to the creation of a valve at the EGJ, the Medigus ultrasonic surgical stapler (ultrasound guided stapling of the gastric fundus to the EGJ) and EsophyX (fasteners to create a 270 ° partial fundoplication), improve symptoms and reduce esophageal acid burden, but long-term durability remains unknown. Endoscopic management is widely utilized for GERD complications. Selecting the appropriate patient is key for therapeutic success with endoscopic GERD therapy. Patients with minimally disrupted EGJ barrier (< 2 cm hiatus hernia) and intact esophageal peristalsis are optimal candidates.