Endoskopische Vollwandplikatur - Eine perorale interventionell/endoskopische Methode zur Therapie der Refluxkrankheit

The burden of gastroesophageal reflux disease (GERD) in Germany is substantial. It is associated with significant morbidity and it negatively impacts quality of life due to typical symptoms like heartburn and acidic regurgitation as well as atypical symptoms like chronic cough, asthma, dental erosions or clinical signs of a laryngitis. Medical acid suppression with Proton Pump Inhibitors (PPI) is the treatment of first choice; in selected patients also laparoscopic antireflux surgery (LARS) is accepted as a highly effective therapy. However, established GERD therapies are costly and especially LARS harbours considerable side effects. Moreover physicians are in some borderline cases uncertain which therapy to apply. These concerns lead to pursue various endoscopic treatment approaches for GERD over the last 15 years. Transoral incisionless fundoplication (TIF) has turned out to be the most promising device. It is an endoluminal procedure which already showed in prospective trials that this endoscopic treatment has the potential to eliminate the need for medical acid suppression with a low risk of side effects by tightening the gastroesophageal junction by full thickness plication.