New Developments in Anti-Reflux Surgery: Where Are We Now?

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Device Technology

Background:

• Gastroesophageal reflux disease (GERD) is a prevalent chronic condition affecting a significant portion of the Western population.
• Management strategies for GERD encompass conservative approaches, endoscopic interventions, and surgical procedures.
• Laparoscopic Nissen fundoplication (LNF) is traditionally regarded as the gold standard surgical treatment for GERD.

Purpose of the Study:

• To evaluate the efficacy and outcomes of alternative surgical procedures for GERD compared to LNF.
• To assess the short- and long-term results of Magnetic Sphincter Augmentation (MSA) and other emerging techniques.
• To provide an updated perspective on the current landscape of GERD surgical management.

Main Methods:

• Review and analysis of existing studies on LNF, MSA, RefluxStop™, and transoral incisionless fundoplication (TIF) combined with laparoscopic hiatal hernia repair (cTIF).
• Comparison of procedural outcomes, including efficacy, safety, and patient follow-up.
• Evaluation of short-term and long-term results and comorbidities associated with each procedure.

Main Results:

• Magnetic Sphincter Augmentation (MSA) demonstrates satisfying short- and long-term outcomes and manages comorbidities effectively.
• MSA is presented as a less disruptive and potentially more standardized laparoscopic alternative to LNF.
• RefluxStop™ and cTIF show promising short-term results, but require further investigation for long-term efficacy.

Conclusions:

• Laparoscopic Nissen fundoplication (LNF) remains the current gold standard for surgical GERD treatment.
• Magnetic Sphincter Augmentation (MSA) is identified as an equivalent alternative to LNF.
• Emerging procedures like RefluxStop™ and cTIF show potential but necessitate additional long-term studies for definitive conclusions.