The GERDX procedure, also known as ‘Endoscopic Plication’, is a minimally invasive procedure used in the treatment of Gastro-esophageal reflux disease (GERD). The procedure is performed endoscopically from inside the patient’s stomach under general anesthesia through stapling to prevent gastric juices from escaping into the esophagus.
By being less invasive, having fewer side effects, and without limiting future treatment possibilities, the GERDX system bridges the large treatment gap between medication, long-term use of proton pump inhibitor (PPI) therapy, and more invasive surgical methods.
GERDX Treatment Procedure
The GERDX procedure, which attains similar results to those of well-known surgical procedures, has the major benefits of being less invasive with significantly lesser side effects. Additionally, the procedure does not stop or limit other treatment options if required in the future.
GERDX procedure is performed under general anesthesia or deep sedation in four steps:
Step 1: In the first step, the applicator is gently placed into the stomach via the mouth and esophagus using an endoscope and a guidewire. The front half of the applicator is fully retroflexed, whereby the arms are opened, and the Tissue Retractor introduced into the tissue.
Step 2: The Tissue Retractor is then placed deep inside the gastric cardia mucosa (area of mucosa located distal to the gastroesophageal junction). The gastric wall is then withdrawn into the applicator’s open arms by pulling the mechanism back. Since the entire procedure is done endoscopically, whereby there is a light and camera attached on the endoscope, which can move without the retractor, the doctor is able to see the entire procedure on a monitor.
Step 3: The applicator’s arms are then closed, which results in a full-thickness duplication (eFTP, endoscopic full-thickness duplication) of the stomach wall. All the layers of the stomach wall in the target area are sutured through, a process that creates the foundation for long-lasting results of the GERDX procedure.
Step 4: After suturing the Tissue Retractor is removed, and the applicator’s arms are re-opened to release the tissue. The full-thickness duplication and tight closure of the gastro-esophageal connection around the shaft of the applicator are also ensured, after which the arms are closed again, and the applicator straightened, and removed from inside the patient’s stomach.
Possible Risks of GERDX Procedure
Just like any other surgical procedure, GERDX also comes with its own possible risks and complications, which may include:
- Return of the heartburn
- Bloating discomfort
- Excess gas
- Problems while swallowing
- The esophagus moving so that the stomach no longer supports the valve
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