Specialists at Ohio State first in U.S. to use incisionless reflux technique

Specialists in the Department of Surgery at Ohio State University Medical Center recently were the first in the United States to use a new transoral incisionless technique for the treatment of gastroesophageal reflux disease (GERD).

GERD is a condition in which the lower esophageal sphincter, the valve separating the esophagus and the stomach, fails to close and allows stomach acid to back up into the esophagus. The disease can lead to more serious medical conditions, including cancer of the esophagus. Nearly 30 million Americans suffer from chronic GERD.

W. Scott Melvin, M.D.

In the new procedure, the surgeon uses a flexible endoscope to insert a fastener-deploying device called the EsophyX through the mouth into the stomach. There, the surgeon uses the device to place polypropylene sutures, reconstructing the defective esophageal sphincter. The surgeon views the operation using a fiberoptic camera deployed through the endoscope.

The result for the patient is little or no postoperative pain, no external scarring, a faster recovery, and fewer and less severe complications than would be expected with either open or laparoscopic procedures, both of which require incisions. Most patients spend one night in the hospital and are released symptom-free.

The EsophyX has been in use in Europe and recently was approved for use in the United States by the Food and Drug Administration.

“The device offers a treatment for patients who suffer from an advanced degree of GERD, and until now, would have been candidates for surgery,” says Dr. W. Scott Melvin, professor of surgery, chief of the Division of General and Gastrointestinal Surgery, and director of the Center for Minimally Invasive Surgery at the Ohio State’s Medical Center.

Melvin and Dr. Dean J. Mikami, assistant professor of surgery in the Division of General and Gastrointestinal Surgery, have used the EsophyX to treat two patients at Ohio State’s Medical Center, which is one of the nation’s leaders in incisionless surgery.

“Throughout medical history, we have gone from a very painful surgery, to a better-tolerated surgery, and now, to a potentially pain-free incisionless procedure,” Melvin says. “In addition, the new procedure allows a treatment option for many patients whose reflux is not severe enough to require surgery.”