>> [MUSIC].
Gastroesophageal reflux disease or GERD
is when stomach acid goes up into the esophagus,
which is the muscular tube that
goes from your mouth to your stomach.
This can oftentimes create
irritation in the esophagus which patients
often experience as heartburn
or a burning sensation in their chest.
This is sometimes worse when people are laying
down or after eating a meal.
Other symptoms of GERD can
include having a sour taste in your mouth,
regurgitation, or pain when swallowing.
Some people may experience difficulty swallowing with GERD,
but this is an uncommon symptom.
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Difficulty in swallowing can sometimes be
an indication of other disorders
of the esophagus, such as achalasia.
In our group, we specialize in
comprehensive care for these conditions and can offer endoscopic,
laparoscopic, and robotic approaches for these conditions.
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>> In general, there's a wide range of
surgical options for gastroesophageal reflux disease.
Each of them has their own set of pros and cons and candidacy,
and we tailor the approach to the patient.
The first one and the most common is the fund application.
It's a traditional stomach wrap around the esophagus
that uses the powerful muscles of the stomach
to reinforce the lower esophageal sphincter,
and that can be tailored either
as a complete wrap or a partial wrap.
There's great 20 year plus data on
this showing how safe and efficacious it is.
The second option that we offer in
our heartburn center is magnetic sphincter augmentation,
or the lynx device,
which is a magnetic ring of beads that go around
the lower esophagus to reinforce the lower esophageal sphincter.
It's a great option for people who want the benefit of
a complete barrier but want
to preserve the ability to belch and
vomit and don't have trouble swallowing.
Another option that we offer is the combined TIF operation
or transoral incisionless fundoplication.
The TIF was originally designed as a surgical alternative to
patients who didn't want to undergo
surgery but wanted an anti reflux procedure.
It involves placing the device through the mouth
and wrapping the stomach around the esophagus,
partially from the inside.
Now, what we've seen is that a lot of
the failures due to that procedure was due
to a missed hiatal hernia
or an effaced lower esophageal sphincter.
We brought that device into the operating room and we're
actually combining it with
a high dose hernia repair called a combined TIF.
Lastly, in patients that have morbid obesity,
we offer Roux-en-Y gastric bypass,
and those patients who meet criteria,
they can have their GERD treated,
but also reap the benefits of weight loss surgery
and treated comorbidities associated with it.
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The simple answer is that
anyone with gastroesophageal reflux disease can come see us in
our heartburn center to discuss their surgical options for GERD.
In the past, we only saw patients with severe disease
or disease that was medically refractory to medications.
Thankfully now we're seeing patients much sooner in
the disease process with milder symptoms,
and we're able to intervene much sooner
before they develop severe disease.
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