Endoscopic Antireflux Procedures

Abstract

Gastroesophageal reflux disease (GERD) is one of the most commonly diagnosed diseases in the United States. In the modern era, the mainstay of GERD management has been effective medical therapy, which has been helped in recent years by the widespread availability of the proton pump inhibitor (PPI) class of antacid medications. However, either due to contraindications to medications or concerns regarding the long-term safety profiles of PPIs, there are a select group of patients who would benefit from a more interventional approach to GERD management. While surgical antireflux procedures have been the standard of care for years, recently there have been major developments in less-invasive endoscopic techniques for reflux management. In this chapter, we discuss recent developments in endoscopic approaches to reflux management that represent the leading edge of innovation for the management of GERD. This chapter describes the preoperative preparation, pitfalls and danger points, operative strategy, and identification of complications. Step-by-step technical instructions, supplemented by operative photographs, are included. The chapter concludes with a list of selected references.