- Effective, minimally invasive and robotic surgical procedures are available
- Offering LINX Reflux Management System
- Surgery is an option for the long-term management of GERD
The Minnesota Heartburn & Reflux Center offers the best surgical solutions for GERD that are available. The most common reason these GERD treatments are chosen is failure of available medications to relieve acid reflux symptoms to a patient’s satisfaction. Other reasons may be the inconvenience and cost of taking daily medications, the desirability to actually stop the reflux (which medications cannot do) or drug side effects.
Laparoscopic Nissen Fundoplication
The “gold standard” to which all antireflux surgical procedures are compared is the laparoscopic Nissen fundoplication. Its effectiveness has been proven. The “Nissen” is performed under general anesthesia using a slender scope passed through several very small incisions. The Nissen works by restoring the function of the damaged valve that is the actual cause of acid reflux. This is done by wrapping part of the stomach very loosely around the lower esophagus at the location of the lower esophageal sphincter (LES).
The Reflux is stopped in 80-85 percent of patients eliminating the need for medications. The same percentage of patients are satisfied with the procedure after eight to 10 years and would have it again. There are some side effects with this procedure, which are discussed in detail with patients by the Minnesota Heartburn & Reflux Center staff.
Lower Esophageal Sphincter Augmentation
A new treatment available for GERD is called the LINX Reflux Management System. The Minnesota Heartburn & Reflux Center was selected as one of the initial centers nationally to offer this GERD treatment.
This implantable device is a small bracelet composed of titanium magnets connected by a wire. It is placed around the esophagus at its junction with the stomach. It does not compress the esophagus in any way, but “augments” the defective lower esophageal sphincter. The magnets separate, expanding the bracelet allowing food to pass and then come together again, augmenting the sphincter and its function in preventing reflux.
In the most recent study, 100 patients who had the procedure were followed for five years. Eighty five were off of all PPI medications and there were no significant side effects. The reflux was stopped in 70 percent of patients. Ninety one percent would undergo the procedure again and 94 percent would recommend it to a friend.
Gastric Exclusion and Diversion
In severe GERD with extensive esophagus damage and impaired swallowing, or failed previous ant-reflux procedures; a more complex treatment may be indicated. In this minimally invasive procedure, the acid producing portion of the stomach is divided creating a small gastric pouch at the base of the esophagus. The gastric secretions created in the excluded portion of the stomach are then diverted away from the esophagus to a distal portion of the small bowel eliminating acid backflow into the gastric pouch and esophagus. This procedure can be beneficial for patients who are experiencing additional health threatening illnesses as well as GERD.(sorry the formatting will not conform for normal spacing)
The experts at the Minnesota Heartburn & Reflux Treatment Center can inform you about the benefits and risk of each procedure as you evaluate surgical alternatives. They will assist in the understanding of each option and work with you so that a shared informed decision can be made.
Cellvizio and Tissue Biopsy
Because patients with Barrett’s Esophagus have an increased risk of developing esophageal cancer, the Minnesota Reflux and Heartburn Center specialists may recommend keeping an eye on it through regular endoscopies. During an endoscopy, Cellvizio Optical Biopsy helps the doctor pinpoint areas that may need further examination, which means a reduction in biopsies. Cellvizio Optical Biopsy may also help the doctor detect more malignant lesions through better sampling, especially in areas that appear normal under endoscopic examination alone. It can also help him or her to choose the right treatment for you and to evaluate whether a current treatment is going well.
Optical biopsy with Cellvizio enables doctors to examine tissue at the microscopic level during an endoscopic examination facilitating traditional tissue sampling and even potentially reducing the need for a separate and evaluation.
As a physician examines a patient’s esophageal tissue using Cellvizio optical biopsy to check for Barrett’s Esophagus or dysplasia within Barrett’s Esophagus, he or she is provided with real-time images that can help determine whether or not cancer is present at that time. This way, trained physicians are able to make faster evaluations, which have the potential to result in quicker treatment of Barrett’s Esophagus and associated problems.
If you are faced with the need to confirm a diagnosis for Barrett’s Esophagus, or if you have Barrett’s Esophagus and wonder whether optical biopsy can enhance your surveillance and/or treatment, ask your physician about the procedure using Cellvizio.
Radiofrequency Ablation (RFA)
A medical procedure in which part of the electrical conduction system of a dysfunctional tissue is ablated using the heat generated from medium frequency alternating current. Radiofrequency ablation for cancer is a minimally invasive procedure that uses electrical energy and heat to destroy cancer cells.
Radiofrequency ablation may be an option for treating precancerous cells in the esophagus that are associated with Barrett’s esophagus. During radiofrequency ablation for cancer, imaging tests are used to guide a thin needle through the skin or through an incision and into the cancer tissue. High-frequency energy passes through the needle and causes the surrounding tissue to heat up, killing the nearby cells. Radiofrequency ablation for cancer is typically an option when surgery isn’t possible, such as if you have other health problems that make surgery.
Transoral Incisionless Fundoplication
The Transoral Incisionless Fundoplication (TIF®) procedure is based on established principles of surgical repair of the anti-reflux barrier, except that it is “surgery from within” performed through the mouth with an endoscope—the same equipment used to diagnose gastroesophageal reflux disease (GERD). The procedure reduces a hiatal hernia and rebuilds the valve between the stomach and esophagus restoring the natural, physiological anatomy to prevent GERD. Because the procedure is incisionless, there is reduced pain, reduced recovery, and no visible scar.