Thomas Jefferson University Hospital is the first hospital in Philadelphia, and the Delaware Valley, offering endoluminal fundoplication (ELF) an incisionless surgical treatment option to provide long-term elimination of gastroesophageal reflux disease (GERD), one of the most common gastrointestinal diseases affecting hundreds of thousands of people, in which the esophagus becomes inflamed by digestive acid backing up from the stomach, resulting in heartburn.

"This is a viable alternative to traditional open or minimally invasive surgery and also provides patients with another alternative to taking a daily medication, like a proton pump inhibitor to reduce acid, for the rest of their lives," said Benny Weksler, M.D., assistant professor, Department of Surgery. "Not only is it effective, it is absolutely incisionless which reduces a patient's healing time and hospital stay. It also is significantly less painful, causes no visible scarring, reduces blood loss and potentially eliminates the need for pharmaceutical treatment of GERD."

ELF involves inserting an endoscopic device through the mouth and into the stomach to access and reconstruct the gastroesophageal valve, thereby preventing reflux of stomach contents into the esophagus and throat. The procedure is performed with the patient under general anesthesia and typically takes less than an hour to complete.

Once the endoscopic device is advanced into the esophagus, the Jefferson surgeon utilizes a video camera inserted down the central shaft of the device. He then forms and fastens several tissue folds, or plications, to create an anti-reflux valve at the gastroesophageal junction, resulting in the effective elimination of GERD. Most patients go home the next day and can return to work and most normal activities within a few days. In the weeks following surgery, a natural healing process fuses and cements the plications to create a durable anti-reflux barrier.

Prior to this type of surgery, patients would either be prescribed daily medication to suppress the amount of acid the stomach makes (usually a proton pump inhibitor) or undergo open, or laproscopic, surgical manipulation of the stomach and esophagus to reduce symptoms.

The parameters to qualify for the ELF procedure require that interested patients not be obese (a body mass index less than thirty) and have unsatisfactory results from daily acid-suppressing medications.

Source: Thomas Jefferson University