Recently, McGowan Institute for Regenerative Medicine
faculty member Alejandro Nieponice, MD, a Research Assistant Professor of the department of surgery at University of Pittsburgh as well as the program director of Minimally Invasive Esophageal-Gastric at the Foundatión Favaloro (Argentina), performed a new endoscopic surgical procedure where the surgeon enters through the patient’s mouth to repair damage from gastroesophageal reflux disease (pictured). McGowan Institute faculty member Blair Jobe, MD, associate professor of surgery in the Heart, Lung and Esophageal Surgery Institute at the University of Pittsburgh and UPMC, attended the innovative procedure.
For those who suffer from gastroesophageal reflux – a condition best known for its primary symptom, heartburn – relief can be found through pump inhibitor proton medication. This is a lifetime treatment that for some may not be feasible. There are patients who do not want or are unable to take medication for life, but for whom laparoscopic surgery is considered too invasive.
As reported by Sebastian A. Rios in La Nacion,
a daily periodical in Argentina, a new alternative is currently being investigated at the Favaloro Foundation in Argentina. This endoscopic surgery does not require any incisions in the skin, but instead the surgeon enters the digestive tract through the mouth. Dr. Nieponice performed the surgery along with chief of gastroenterology at the institution, Fabio Nachman, MD. Dr. Jobe, who attended the novel procedure, said, “The most appropriate patient for this treatment is the patient who relies on medication to avoid symptoms.”
There is another reason why some may consider this alternative treatment. "We are seeing that the medication impairs absorption of calcium,” Dr. Jobe explained. This suggests a link between chronic use of pump inhibitor proton medications and a higher incidence of hip fractures. Dr. Nieponice warns that, while this procedure may provide relief for many, it is not for patients with hiatal hernia, a condition sometimes associated with gastroesophageal reflux.
Gastroesophageal reflux, also called acid reflux or acid regurgitation, occurs when the lower esophageal sphincter does not close properly or else opens spontaneously, which allows stomach contents to enter the esophagus. The esophagus is not able to handle stomach acid and becomes injured, causing heartburn. Drug treatment aims to reduce acid production, while, in more extreme cases, surgery is performed to reconstruct the natural barrier that prevents stomach contents from leaking into the esophagus.
Illustration: La Nacion, courtesy of Favaloro Foundation (Argentina).
La Nacion (12/06/09)
The Nation (English translation) (12/06/09)
Bio: Dr. Alejandro Nieponice
Bio: Dr. Blair Jobe