Sharon Close has been diagnosed with severe gastroesophageal reflux disease (GERD)without the dysplastic changes of Barrett's esophagus.Her GERD is unresponsive to proton pump inhibitors and histamine blockers.She also has a history of endometriosis with multiple surgeries for ablation of endometrial implants on her small bowel and adhesiolysis.Her surgeon is hesitant to pursue an open or a laparoscopic Nissen surgical approach.What procedure might her surgeon consider in lieu of a Nissen?

Question

Quizplus · Accepted Answer

Endoluminal plication is an antireflux procedure that can be performed endoscopically in an endoscopy procedure room using moderate sedation or a general anesthetic.One example is the EndoCinch (Bard Medical)technique that dilates the lumen of the esophagus before passing the EndoCinch device through an EGD scope.The device is a sewing capsule that pinches or pleats mucosal folds and anchors them in place with suture.Several plications are placed in a circumferential or staggered vertical pattern.Another device is the Wilson-Cook sewing system (Wilson-Cook Medical).It is a submucosal plication device that suctions a small fold of tissue into the lumen of the scope accessory,and then plicates,sutures,and knots the tissue pleat.

Sharon Close Has Been Diagnosed with Severe Gastroesophageal Reflux Disease