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Gastroesophageal reflux: new surgical solutions

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With the advice of prof. GUIDO COSTAMAGNA, Full Professor of General Surgery and Director of the Operative Unit of Digestive Surgical Endoscopy of the “A. Gemelli ”in Rome; let’s discover the new solutions to gastroesophageal reflux.

It affects 2 out of 10 people in Western countries and 7 million Italians more or less chronically. And the gastroesophageal reflux, “A disease – explains Professor Guido Costamagna – characterized by the ascent of the gastric contents from the stomach to the esophagus and, sometimes, to the mouth. In reality, it is a phenomenon that occurs daily, even in subjects who do not have disorders, and which becomes pathological when the episodes are very frequent and annoying.

When the pathology is triggered

Fortunately, only in rare cases the gastroesophageal reflux however, it can lead to complications, such as erosioni e ulcers on the esophageal mucosa to cause Barrett’s esophagus, that is, the transformation of the esophageal mucosa into a mucosa similar to that of the intestine, more resistant to aggressive factors.


Read also: Gastroesophageal reflux: symptoms and treatments


It is a defense mechanism put in place by the esophagus to cope with the prolonged insult of the reflux. It is diagnosed by biopsies to avoid the risk of transformation into more serious changes such as, for example, cancer of the esophagus. Treatment is generally pharmacological. But today there is something new: a minimally invasive intervention which guarantees very satisfactory results in resolving the disorder.

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The surgical novelty

The operation it is done on the way laparoscopic and is reserved for those patients who do not find any benefit in taking drugs or who wish to stop taking them. The aim of the surgery is to improve the closing force of the cardia (valve muscle structure located between the esophagus and stomach) by means of a sleeve created around the esophagus with a part of the stomach.

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This intervention can be performed in laparoscopy (5 small holes on the abdomen, operating from the outside) and the long-term results are satisfactory (with success rates close to 80-90%, even after some time). Extremely innovative is a new intervention technique that involves access from the mouth of an ultrasonic stapler.

It is called Medigus Ultrasonic Surgical Endostapler (Muse) and combines one surgical stapler to a miniaturized video camera. The operation, less invasive than that performed in laparoscopy, involves total anesthesia or deep sedation to keep the patient’s breathing under control.

It cannot, however, be performed on patients with a large one hiatal hernia (greater than 2 cm). At the moment, given the novelty of the Muse technique, there are no reports on its success rate after some time.


You may be interested in: Gastroesophageal reflux: symptoms and causes


Help from the table

food intolerances

There are foods gives to limit to avoid the aggravation of symptoms e prevent reflux. Therefore, avoid fatty or fried foods, oils, chocolate, peppermint, spearmint and whole milk. Citrus and citrus juices, coffee (regular and decaffeinated) and tomato also irritate the lower portion of the esophagus and should be limited.

The musculature of the esophagus can also be weakened by other factors such as smoking, chewing gum and hard candy. Other recommendations are: eat small portions of food during meals; do not go to bed after a meal and raise the head of the bed by 20-30 cm.

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