Endoscopic procedures for the treatment of reflux have recently emerged, which are quite advanced and have the potential to cure reflux via a transoral route without surgery.. If successful, such approaches are likely to be very appealing to patients in need of gastroesophageal reflux treatment.
One such frequently used method to treat Gastro-Esophageal Reflux Disease is the Stretta procedure.
What is Stretta?
The laparoscopic Stretta procedure is a minimally invasive surgical technique used to treat gastroesophageal reflux disease (GERD) or chronic acid reflux. GERD occurs when stomach acid flows back into the esophagus, causing symptoms such as heartburn, regurgitation, chest pain, and difficulty swallowing. The Stretta procedure aims to strengthen the lower esophageal sphincter (LES), the muscular ring that divides the esophagus from the stomach, to reduce acid reflux.
The STRETTA catheter is an FDA-approved, specially designed-device with a balloon and four needles. The catheter is linked to a control module, which delivers precisely monitored and controlled amounts of radio-frequency energy to the LES muscle.
How does Stretta work?
The entire Stretta procedure is categorized into two parts. While the patient is sedated, an upper endoscopy, or EGD, is performed. This allows the doctor to precisely measure the distance from the mouth to the LES or sphincter muscle between the esophagus and stomach. After measuring the distance, the doctor will insert the STRETTA catheter through the mouth for precise measurement. The balloon is then inflated, the needles are inserted into the sphincter muscle, and radio-frequency energy is transmitted through the needles.
Understanding the mechanism
Radio-frequency energy is transmitted via the needles in the STRETTA catheter during the STRETTA procedure. This causes pinpoint areas of heat to form in the sphincter muscle, which stimulates the muscle and causes an increase in muscle bundles and muscle fibers within each bundle. As a result, the sphincter is remodeled and becomes thicker, stronger, and longer (similar to the muscles of a weight lifter), and thus relaxes less frequently.
There are two major effects that occur as a result. The first effect, known as the barrier effect, is mostly temporary. The tissue immediately swells or edematizes, and the body deposits a substance called collagen into the sphincter muscle. The thickened area aids in the immediate reduction of stomach contents reflux into the esophagus. While this effect lasts for a while, the swelling or edema will eventually disappear within the first few days; however, most of the collagen is removed by the body much later, and some tissue thickening appears to remain. Collagen reabsorption usually takes 2-3 weeks.
The remodeling or muscle hypertrophy effect is the second and more permanent effect. This refers to the actual increase in muscle size and quantity.
What does the research say about the Stretta procedure?
Medical research has clearly demonstrated that as a result of sphincter remodeling, the muscle’s compliance changes, resulting in a stiffer, stronger sphincter, causing the number of Transient lower esophageal sphincter relaxation (TLESR) to be significantly reduced, and symptoms to usually disappear completely.
What should you expect from the Stretta procedure?
Because of the sedation, you should expect to be extremely tired for the rest of the day immediately following the procedure. Some patients complain of a sore throat or mild chest pain. After the procedure, you will be able to eat with some mild dietary restrictions and resume your normal medications. When you eat, you may notice that the food moves slowly down into your stomach.
You must continue your acid-reducing medications for at least another 4-8 weeks unless otherwise directed by our doctor.
Your reflux symptoms are unlikely to improve right away. The STRETTA procedure is a long-term treatment for heartburn or reflux. The effects usually appear gradually over time. It is critical that you do not expect instant results. It may take up to few months for the final improvements to be realized.
What are the benefits of Stretta?
The benefits of the Stretta procedure include:
- Minimally invasive: The procedure is performed using endoscope via mouth , leading to reduced postoperative pain, shorter hospital stays, and quicker recovery compared to laparoscopic surgery or traditional open surgery procedures( fundoplication)
- Low complication rate: The Stretta procedure has been associated with a low rate of complications, making it a relatively safe option for selected GERD patients.
- Outpatient procedure: In many cases, the Stretta procedure can be performed as an outpatient process, enabling patients to return home on the same day as the surgery.
- Decreased need for medications: Medications, such as proton pump inhibitors (PPIs) can have potential side effects with prolonged use. The Stretta procedure can aid in reducing the need for long-term use of such acid-reducing medicines.
- Improvement in symptoms: Studies have shown that the Stretta procedure can lead to significant improvement in GERD symptoms and quality of life for many patients.
Seamless Stretta Procedure at our Laparoscopic Centre
Led by a seasoned endoscopic/ laparoscopic surgeon Dr. Girish Juneja who has over 30 years of experience, our centre offers this minimally invasive procedure with required skills who can help you find relief from GERD and its related symptoms.
We strive to provide exceptional patient care and are dedicated to guiding and helping our patients achieve their desired outcomes as quickly and safely as possible.
If you’re interested in learning more about the Seamless Stretta Procedure, please contact us today!