ENDOSCOPIC TREATMENT OF GASTRO-ESOFAGIC REFLUX DISEASE - ARMS-A TECHNIQUE

We present an endoscopic approach to the management of gastroesophageal reflux disease (GERD) using an anti-reflux mucosotomy technique (ARMS-A), employed as an option on patients with refractory GERD with proton-pump inhibitors (PPI) and who refuse surgery. The technique is performed in retroflexion, with the application of argon-plasma on the gastric mucosa of the gastro-esophageal junction, creating a circumferential mucosal ulceration and consequently leading to a narrowing of the gastric cardia opening. The scar formation after healing leads to a fundoplication-like effect. This is a simple technique, may allow discontinuation of the PPI and promises a sustained relief of symptoms.