The Future: Endoscopic Antireflux Repair Via The Endo-Organ Approach

Operative techniques for gastroesophageal reflux disease (GERD) include the Nissen fundoplication, the Hill posterior gastropexy, the Belsey Mark IV fundoplication, the Toupet fundoplication, the Angelchick prosthesis, and laparoscopic antireflux surgery. Recent advances in access and instrumentation have made possible endo-organ techniques such as transanal endoscopic microsurgery, endo-organ pancreaticocystogastrostomy, endo-organ gastric excision, and correction of GERD by purely endoscopic means. New endoscopic therapies for GERD include the use of injection techniques, an endoscopic sewing machine, endoscopic invagination and fixation of a nipple valve, and intraluminal valvuloplasty. Further investigations pursue the goal of reducing postoperative discomfort while preserving the established mechanics of corrective surgery.