Montefiore Medical Center, Bronx, NY, has introduced a natural orifice surgery through the mouth, to relieve gastroesophageal reflux disease (GERD), most commonly known as acid reflux. Since this natural orifice transluminal endoscopic surgery (NOTES) does not require any incisions, recovery is faster and it is essentially scarless.
"This procedure represents the next step in the evolution of surgery, which can greatly enhance the quality of life for people who suffer from acid reflux," said Diego Camacho, MD, director of minimally invasive and laparoscopic surgery at Montefiore and one of only a small number of surgeons performing this surgery in the United States since it was approved by the FDA. "The procedure through the mouth can be an option for patients who otherwise would be on reflux medication their entire lives, and it is less invasive than past surgical options and results in reduced pain and discomfort."
According to Camacho, a rod-like instrument enters the esophagus transorally rather than through an abdominal incision and is advanced into the esophagus under visualization of a video camera inserted down the central shaft of the device. The device then forms and fastens several tissue folds to reconstruct the antireflux valve, which creates a durable antireflux barrier. "This procedure reconstructs the antireflux valve and restores the body’s natural protection against reflux," said Camacho. "It provides a solution that treats the cause of acid reflux by restoring the body’s natural protection against reflux and stops further deterioration to the esophagus."
The procedure takes 45 to 60 minutes, and the patient normally goes home the next day without taking pain medications.
