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.
