59 years old man with PPI dependent GERD and pathologic esophageal acid exposure as documented by percentage time esophageal PH less than 4 of more than 4.2% on PH-metry during 24-hrs period while off PPI. the procedure involves ablation of the mucosa of the EGJ using a Hook knife (ARMA) Markings were placed using the Hook knife connected to an electrocautery generator in spray coagulation mode (40 W, effect 2). Mucosal ablation was planned around the cardia on the gastric side in a butterfly shape with width of approximately 1.5 scope diameter, leaving two contralateral areas of normal cardia mucosa with approximately one scope diameter, to avoid stenosis. Durataion was 65 min. patient was discharged 6 hours after procedure.
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