It is retreating of diet consumed from stomach to esophagus due to leakage or insufficiency of the lower esophageal sphincter. Risk factors: hiatal hernia, obesity, low voltage of lower esophageal sphincter, fatty foods, wine, spicy spices, sudden changes in body position, Zollinger-Ellison syndrome. The diagnosis for this disease: contrast X-ray, upper gastrointestinal tract endoscopy, pH-metry, manometry, omeprazole test . Untreated may lead to series of severe complications (gastrointestinal bleeding, adenocarcinoma).
a) GERD (gastroesophageal reflux) - a group of clinical symptoms and / or changes in the esophageal mucosa which are caused by recurrent episodes of getting the gastric contents into the esophagus (endoscopic should be confirmed);
b) NERD (non erosive reflux disease) - 24 h pH-metry shows regurgitation into the esophagus, but there are no visible symptoms in endoscopy.
Symptoms - esophageal symptoms (heartburn, retrosternal pain), associated with organ failure (esophagitis, Barrett's esophagus, adenocarcinoma) and others (cough, hoarseness, asthma, dental caries, chronic laryngitis). Quality of life is reduced due to complaints.
Is several stages (depending on the severity of symptoms):
a) modification of lifestyle - avoiding stimulants (coffee, alcohol), reduction of body weight, regular consumption of meals;
b) pharmacotherapy - used proton pump inhibitors, antacids;
c) the operation - usually performed by laparoscopic Nissen fundoplication.
Other types of reflux
a) bile reflux into the stomach (pyloric sphincter insufficiency); ulcers may occur;
b) vesico-ureteral reflux - here is the reverse flow of urine from the bladder and ureters to the kidneys, can lead to serious complications;
c) reflux of duodeno-gastro-oesophageal reflux - regurgitation of duodenal contents into the stomach and esophagus;
d) laryngo-pharyngeal reflux - stomach contents move to the larynx, pharynx, sinuses, oral cavity, nasopharynx, middle ear.
We have the pleasure to invite you to the first ever combined ANZGOSA-OSSANZ conference on Hamilton Island, Australia in October 2015.
There are many areas of common interest between the two groups and this will be an opportunity for everyone to share...
Control endoscopy after PDR Whipple type whith: gastroentero- and enteroenterostomy. Essential reflux gastritis is observed, but stomies are permeable whithout inflamation and stenosis (courtesly of prof....
Dr Nagi Safa is sharing his experience in Laparoscopic Gastric Plication Surgery (LGCP). In this video, Dr Safa is performing a gastric plication with anti reflux procedure, as one day surgery. The patient...
Medialization of the right crus of diaphragm for closure of large hiatal defects.
Video by Chet Royals MD,Bestoun Ahmed MD,Ziad Awad MD.
Video is a lecture about usefulness of endoscopy in gastric reflux (GERD), Barret's esophagus and bariatric surgery. Presented by W. Scott Melvin, M.D.
Surgery for reflux is relatively simple but the technique includes a lot of small details. We present a very detailed video for the anatomy and technique of nissen fundoplication for GERD.
At present, GERD may be treated using the new method - the LINX device. This mini-invasive procedure assists in preventing a reflux using the force of magnetic beads, making the lower esophageal sphincter...
A new technique, that brings the week lower esophageal sphincter back to it's normal functionality is called the LINX. Many of magnetic beads are connected by titanium links allowing the beads to open...
Type I hiatal hernia and gastroesophageal reflux disease.
This video presents laparoscopic Nissen Fundoplication for GERD (Gastroesophageal Reflux Disease) treatment.
In this video you can see a presentation on robotic and endoluminal management of gastroesophogeal reflux disease.
The Esophyx TIF 2 device is widely used in gastroesophageal reflux disease or slight hiatal hernia treatment. Fully ambulatory management is its great advantage. Almost 80% of patient can push away their...
Laparoscopic antireflux surgery is a minimally invasive approach to correct GERD. Most commonly a laparoscopic Nissen fundoplication is performed. In this procedure the weakened lower esophageal sphincter...
Biopsy revealed the lesion to be adenocarcinoma
An ulcerated obstructed neoplasia is seen at the gastric antrum. This 56 year- old male, who presented with early satiety and postprandial vomiting, suggestive of gastric outlet obstruction, along...
In this endoscopic sequence a reflux esophagitis is observed due to an obstructed gastric cancer of the antrum
Carcinoma of the antrum causing high grade stenosis. Biliar reflux is observed that covers the necrosis.
A follow up one year after. Retroflexed maneuver.
A follow up one year after.
In this image we can appreciate the nodule with some foreign body reaction to the nylon thread. This seems to facilitate the development of the fibrosis and increase the resistance of the sphincter....
In this retroflexed image are observed two nodules of the endoscopic gastroplicature.
Retroflexed image, where two nodules can be seen. These nodules were formed with the junction of the tissues, Besides, an inflammatory reaction is observed, due to foreign body reaction to the nylon...
The image and the video clip display two nodules as results of previously endoluminal gastroplicature six months ago. Two clips of titanium are observed.
Transoral Endoluminal Gastroplications. A follow up after six months. We practiced two endoscopicEndoluminal Gastroplications. She has been our first patient with this new endoscopic suturing method....
Retroflexed image of the gastric fundus the final status of this procedure.
Another appreciation of the endoluminal gastroplicature.
This image and the video clip display the first intraluminal gastroplicature.
In the image and the video clip you can see the placement of the titanium clip through the clamp performing the first gastroplicature in this patient.
The threads are observed which approaching the tissues.
Endoscopic suturing causes modest but significant improvement in LES function. First, there is a significant reduction in the triggering of transient LES relaxations (tLESRs) and second, there is a...
A 62 year-old female who has been presenting gastroesophageal reflux for 8 years. A hernia of the hiatus with an extended defect is observed which affects the closing mechanism and contributes to...
The knot is observed, the threads and the titanium clip The first stich is finish of this form increase the pressure of the inferior gastroesophageal sphincter, this procedure is simple, two to four...
In this step this clamp is withdrawn, the hole of the clamp is observed where the titanium knot is applied and the threads are cut, also this clamp is equipped to cut threads.
Video Endoscopic Sequence
The next step is to perform the knot. The titanium knot mechanically fastens suture together and cuts away excess suture. And those threads position close to the mouth and out from the patient are...
The image and the video are displaying both threads that were observed as four, This happened because they were tractioned outwards. In the image show two threads that previously were four, but after...
We look the 4 threads that convert to two with applied traction that is direct out and both tissues gathered together.
We prepared the second suture one centimeter away from the first one. In the image observed the process after the tissue which we deliver one suture, with this device. We observed the threads through...
The image and the video clip display to loosen the tissues, certain maneuvers are observed, we prepared the second suture one centimeter away from the first one. In the image observed the process after...
The ESD Flexible Endoscopic Suturing device. It uses the same principal of tightening the junction between the esophagus and the stomach by the placement of sutures. This device has been approved by...
Suturing System and standard video endoscopy, sutures are placed in the upper part of the stomach at or just below the LES. Two stitches can be placed and tied together to create a pleat near the...
Endoscopic Suturing due to chronic gastroesophageal reflux. The image and the video display a retroflexed hiatal hernia. A 35 year-old male, who has been suffering of suffering refracting Gastro Esophageal...
Final statust of the endoscopic gastroplicature. Patient relief the symptoms. Plication of the gastroesophageal junction by endoscopic suturing has been reported to improve symptoms and reduce acid...
The gastroplication has been completed. Plication techniques create a mechanical barrier to reflux through apposition of 2 mucosal surfaces at the gastroesophageal junction or in the cardia. The mechanisms...
The flexible Ti-Knot Device has been placed the titanium clip performing the knot.
The image and the video clip display the traction exerted by the treads that tied the tissues.
The 4 threads has been converted in 2.
4 treads are observed after traction is performed, they will become in 2, after that a titanium clip will be placed to perform the knot.
The video clip displays the flexible Sew-Right Device has been released the tissues (the suction is turned off) with gently movements is withdrawing.
A clamp with threads is suctioning the gastroesophageal junction.