New techniques and technologies for the treatment of GERD are being explored. Two of the newer approaches to treating internal abnormalities that cause GERD are:

• Stretta® Procedure Using the Stretta System

• Transoral Gastroplication, or Endoscopic Suturing

The American Gastroenterological Association or AGA states the following regarding these procedures: 

"Recently, less invasive endoscopy techniques have been developed to tighten the esophagus/stomach barrier. However, the safety and effectiveness of these new alternatives to surgery are still being determined." (link to AGA site)

The Stretta procedure is a transoral, or through the mouth, way to treat GERD. The procedure requires no cutting or sewing and leaves no skin incisions. It is performed under heavy sedation, but the patient is still conscious. It can be performed in an outpatient setting but is not recommended for patients who have a hiatal hernia over 2 centimeters, have achalasia, or incomplete relaxation of the lower esophageal sphincter in response to swallow.

Transoral gastroplication, or endoscopic suturing, uses a medical device called the Bard EndoCinch™ Suturing System.¹¹ The surgeon creates and sews pleats into the lower esophageal sphincter. Each pleat is called a plication, and several plications may be created. Each pleat tightens and strengthens the lower esophageal sphincter.

Endoscopic suturing can be performed in an outpatient setting and usually takes one to two hours. Patients are deeply sedated and local anesthesia is used. Some patients may require several treatments. Endoscopic suturing is not right for patients with severe airway restriction and is not recommended for patients who have a hiatal hernia.