Mini invasive transendoscopic and laparoscopic treatment of gastroesophageal reflux disease

The purpose of the article is to present, based on the data collected from the literature of specialty, new considerations regarding the treatment through miniinvasive transendoscopic and laparoscopic procedures of the patients diagnosed with gastroesophageal reflux disease (GERD). The 3 procedures of the miniinvasive transendoscopic treatment of GERD, mentioned bellow have shown a significant improvement of the parameters related to the quality of life. Due to the action of high frequency currents at the gastroesophageal junction level, Stretta procedure creates a collagen contraction followed by a reduction of the esophageal lumen. After successive sutures, the "EndoCinchTM" endoscopic suture system described by C.R. Bard realizes a pleat on the inferior esophagian sphincter recovering the valve mechanism. The endoscopic submucosal implant of inert polymers (microspheres of plexiglas/beads of polymethylmethacrylat = PMMA) within the pleats of the inferior esophagus remakes the valve mechanism by pleats expansion. The miniinvasive surgical treatment of GERD (laparoscopic antireflux operations) generates through different techniques, still much debated by the literature of specialty (Dor, Toupet, Nissen, Rosetti, etc.), an increased pressure at the level of esophageal sphincter. In conclusion even are expensive, the medical and miniinvasive surgical treatments have given the best results. The miniinvasive transendoscopic procedure follows to be evaluated in the future by long term comparative trials.