changes that occur with fundoplication.
Incidentally, for morbidly obese patients who suffer with GERD, I'd
typically recommend bariatric surgery over LINX or fundoplication.
By bypassing the stomach, you kill 2 birds with 1 stone, reducing the
patient's weight and improving reflux. In other words, why just put a
finger in the dike when you can fix the dike?
On the horizon?
Still awaiting approval is another promising minimally invasive surgical
option, the EndoStim. It's implanted in the abdomen and consists of a
stimulator and 2 electrodes. The idea is to restore normal esophageal
function by stimulating the lower part of the esophagus. Only about as
big as a box of matches, it's looked promising in trials, and the proce-
dure to implant it will likely be the easiest of all to perform.
OSM
1 1 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 7
Dr. Fass (ronnie.fass@gmail.com) is the director of the Division of
Gastroenterology and Hepatology, the head of the Esophageal and Swallowing
Center at the MetroHealth Medical Center in Cleveland and a professor of medi-
cine at Case Western Reserve University in Cleveland.
