17 - Freie Mitteilung
15. Mai 2019, 13:30 - 15:00, Bellavista 2, 6. OG
Video: The treatment of gastrooesophageal reflux disease (GERD) by RefluxStopTM device implantation
A. Büsser, O. Schöb, Presenter: A. Büsser (Zürich)
127 million European’s suffer from gastrooesophageal reflux symptoms caused by a disruption of the physical barrier between the oesophagus and the stomach. Laparoscopic fundoplication is a proven treatment modality for GERD in cases of poor response of livestyle changes or medical therapy. As a treatment alternative, a new implantable single use sterile device, called RefluxStopTM, was developed to ensure maintenance of the gastro esophageal junction. Its advantage compared to the laparoscopic fundoplication is that this technique doesn’t compress the foodpassageway. A literature review and a meta-analysis has been performed comparing Nissen fundoplication with the results from the RefluxStopTM. It has been shown that the new method has better treatment results and fewer side effects. As part of a post- market prospective open-label multicenter single arm study, we present in a video the implantation of RefluxStopTM.
A 25- year old man, working as a logistician, was diagnosed with severe symtoms of GERD for more than six months. The 24 –hour pH monitoring showed a pathologic oesophageal acid exposure. Due to the increasing need of proton pump inhibitor medication, a surgical treatment seemed most appropriate. After placement of five ports in the upper abdomen, the angle of HIS is reconstructed. On the left side the stomach fundus wall its attached to the oesophagus with three rows of single knobs. The RefluxStop device is positioned and fixed onto the gastric fundus to ensure intra-abdominal positioning of the lower oesophageal sphincter. After confirming the proper placement, the intraabdominal situs is controlled an the access points are closed.
The intra- and postoperative course was uneventful. The routine contrast swallow x-ray on postoperative day one showed a proper position of the device. The patient was discharged on postoperative day three. The follow up visit 6 weeks later showed a patient free of any discomfort.
The implantation of the RefluxStopTM device was feasible and in this case a good treatment alternative in the surgical management of severe GERD. Altough the long term benefits and effectiveness of this new technique have yet to bee proven in further studies.