Minimally Invasive Surgery Promises Lasting Relief From GERD

11-29-2017

Many of us have occasional heartburn—especially when we overindulge. Moderate heartburn can typically be cured with non-prescription antacids. However, persistent, severe heartburn may be a sign of gastroesophageal reflux disease, or GERD.

“GERD is a common digestive disorder where stomach acid leaks into the esophagus, usually because of a weak or damaged sphincter,” says John Shaver, MD, a board-certified general surgeon at Mission Hospital.

Some people make the mistake of brushing off recurrent heartburn as simple stomach trouble, putting themselves at risk of long-term effects.

“Repeated exposure to stomach acid can damage the sensitive lining of the throat and esophageal damage increases the risk of more serious health problems, including ulcers and ‘Barrett’s esophagus,’ which can be a pre-cancerous condition,” Dr. Shaver says.

Now, exciting innovations in minimally invasive surgery offer the promise of long-term relief from GERD—without the potential downsides of drugs.

GERD drugs only treat the symptoms

Aside from lifestyle changes, such as avoiding trigger foods and not eating late in the evening, GERD is first managed with medications—especially drugs called proton pump inhibitors, or PPIs. Popular brand names include Nexium, Prilosec and Prevacid.

By limiting the production of stomach acid, these medications can deliver dramatic positive results quickly, but there are limits. Dr. Shaver says there are two major drawbacks to PPIs:

  • They only attack the symptoms of GERD, not the root cause. “PPIs do not repair the damaged lower esophageal sphincter,” Dr. Shaver says.
  • More troubling, researchers have identified a growing list of adverse side effects with PPIs—from relatively benign problems like chronic magnesium deficiency to serious issues like kidney disease and dementia.

Antireflux surgery uses advanced technology for fast healing

Most antireflux surgeries today are minimally invasive or laparoscopic procedures. Unlike conventional “open” surgery where large incisions are made, laparoscopic surgery utilizes a narrow, tubular video camera and several tiny operating instruments inserted into the abdomen through a few small incisions—each less than a half-inch long. The surgical team uses the camera to view a magnified image of the surgical site to perform very precise and delicate operations.

Robotic antireflux surgery is really just an enhanced form of laparoscopic surgery, but with an extra layer of technology. The surgeon makes the same small abdominal incisions to insert the camera and instruments. However, rather than the surgeon directly moving the instruments, the “robot” holds the instruments while the surgeon sits at a control console a few feet away, operating the robot.

“Robotic or not, laparoscopic antireflux surgery is much better for patients,” explains Dr. Shaver. “They experience less pain, less time in the hospital and faster recovery.”

Other new developments in GERD treatment

In addition to robotic surgery, other leading-edge laparoscopic procedures are also showing considerable promise of long-term relief for GERD sufferers—including the LINX system. A small, flexible band of titanium-wrapped magnetic beads is surgically implanted around the lower esophageal sphincter where it functions like a supplemental lower esophageal sphincter. The LINX band expands and contracts—just like a normal sphincter—allowing food to enter the stomach, but preventing stomach contents from refluxing back into the esophagus.

Unlike medications, surgical treatments directly address the underlying cause of the disease, not the indirect symptoms. For most patients, the treatments are simple outpatient procedures with good outcomes and positive long-term effects.

If you’re picking up a bottle of pink antacid or chalky tablets more than a few times a week, ask your doctor if you have GERD.

Learn more about Dr. Shaver. Learn more about Mission Hospital.