For the first time in Israel, Rambam Health Care Campus (Rambam) in Haifa, Israel is performing procedures to treat reflux using innovative technology, giving patients an artificial solution mimicking the body’s natural mechanism.
L: Professor Assalia; Top R: Diagram of new method using magnetic beads. Bottom R) The surgical team in Rambam's operating room. Photography: Rambam HCC.
According to the American College of Gastroenterology, twenty percent of the US population suffers from gastroesophageal reflux disease (GERD). The percentage is even higher in the Middle East. A fairly common condition that can affect quality of life, GERD is treatable by making lifestyle changes or taking medication. However, in some cases, even these courses of treatment do not solve the issue. Approximately two percent of those suffering from GERD will need surgery to fully resolve the problem.
Recently, a new surgical procedure has become available that is shorter, more efficient, and involves fewer complications. To date, three such surgeries have been performed at Rambam on patients ranging from 30 to 70 years of age, all of whom suffered from prolonged, detrimental reflux that was resistant to drug treatment.
“The new surgery is intended for precisely these types of patients,” clarifies Professor
Ahmed Assalia, Director of the Department of General Surgery and an upper gastrointestinal surgery specialist at Rambam. “Those who suffer from GERD, do not respond to drug treatment, and have normal esophageal motility can undergo this new procedure.”
According to Assalia, medication is not always the most effective solution and in some cases, surgery is the best option. “Many patients remain dependent on drugs for several years, even though their condition does not improve. Taking these medications for years has extensive consequences, especially in young patients. In addition, inappropriate treatment for reflux can impair their quality of life and can also lead to the development of esophageal cancer.”
The new surgery focusses on strengthening the sphincter (a muscle at the bottom of the lower esophagus) by repositioning the upper section of the stomach and forming a fold in the stomach (called fundoplication) around the esophagus. Overall, the surgery involves fewer complications and has an increased probability of controlling the reflux immediately following the operation and over time.
“With this new method, a bracelet consisting of magnetic beads is placed and locked around the lower esophagus at the junction with the stomach,” explains Assalia. “This increases the basic pressure in the lower esophageal sphincter, which prevents reflux without interfering with swallowing. When swallowing, the motion of the esophagus opens the bracelet. As soon as food or drink passes into the stomach, it closes back up. The bracelet serves as a kind of valve and simulates the natural movement that had been impaired.”
The new surgery is performed by a multidisciplinary team as a collaboration between the Department of General Surgery and the Gastroenterology Institute. The first patients in Israel who recently underwent this innovative procedure are already reporting an improvement in their condition. “From the results coming in from other centers performing the procedure worldwide, we expect to see success rates of about 90 percent,” notes Assalia. “Our patients are feeling great and already showing good outcomes. We are pleased to adopt technologies that benefit our patients by offering them suitable solutions that can improve their lives.”
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