Abstract
SocieteInternationale de Chirurgie 2008 Gastroesophageal reflux disease is common in western societies. Up to 40% of individuals in these countries experience at least some reflux symptoms, and the provi- sion of antisecretory medication for the treatment of reflux is now a major cost for all western countries. Established treatments for reflux entail antisecretory medication (usu- ally a proton pump inhibitor) or antireflux surgery (usually achieved laparoscopically). Arguably, neither of these options is ideal. The perfect treatment for gastroesophageal reflux would probably be a single, 100% effective inter- vention, which is undertaken on an outpatient basis and is not associated with any risks or side effects. Currently, neither medical nor surgical therapy meets all of these criteria. Hence, there is scope for improvement, and recently there has been considerable effort directed toward devel- oping a low-risk endoscopic (transoral) procedure that can cure reflux. A range of procedures have been developed and advocated during the last decade. These include the application of radiofrequency energy to the distal esopha- gus (Stretta procedure (1)), endoscopic mucosal suturing (Endocinch (2)), injection of a bulking agent into the wall of the distal esophagus (Enteryx (3) and Gatekeeper (4)), and full-thickness plication of the gastroesophageal junc- tion (Plicator (5)).
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