Incisionless surgery for acid reflux disease

Surgeons at the Ohio State University Medical Center have performed the first incisionless operations in the United States using a device recently approved by the Food and Drug Administration to stop gastroesophageal reflux disease.

Ohio State's Medical Center is one of the nation's leaders in incisionless surgery, a new procedure that leaves no outside scarring; results in minimal, if any, post-operative pain; reduces patients' recovery time significantly; and is expected to be one of the next major medical advancements.

Surgeons at Ohio State have treated the first two patients, using the device known as EsophyX. The mechanism, new in the United States, has been proven safe and effective in patients treated throughout Europe for gastroesophageal reflux disease (GERD), also known as heartburn.

“The medical device offers a treatment for patients who suffer from an advanced degree of GERD and, until now, would have been candidates for surgery,” said Dr. Scott Melvin, division director, general and gastrointestinal surgery, and director, Center for Minimally Invasive Surgery at the OSU Medical Center.

Heartburn is a condition in which acid refluxes from the stomach into the esophagus. The burning sensation felt in the chest can last for countless hours, resulting from inflammation, bleeding or ulcers in the esophagus. GERD is known to be associated with an increased risk of cancer of the esophagus.

Almost 30 million Americans are diagnosed with chronic reflux disease that requires medication for relief of symptoms. It is estimated that millions of dollars are spent on over-the-counter and prescription medications for treatment of the condition.

The incisionless surgery allows reconstruction of the one-way valve at the top of the stomach, when the valve is defective. The new tubular device is introduced to the body totally through the mouth, and is then advanced down the esophagus into the stomach. During the procedure, the operation is viewed through a small fiberoptic camera located within the tubular surgical tools. Patients are normally in the hospital overnight and, after the procedure, are symptom free.

“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. In addition, the new procedure allows a treatment option for many patients when reflux is not severe enough to require surgery,” noted Melvin.

“We are far from incisionless technology's adoption for widespread use with other diseases, but there is a lot of discussion among surgeons about these new techniques,” said Melvin. “Our use of this type of technology will continue to allow us to treat many diseases with minimal pain from surgery.”