How to Have GERD Surgery Without Incisions

By Patricia Salber MD, MBA (The Doctor Weighs In)

Graphic Source: Adobe Stock

What is GERD?

GERD occurs when the lower esophageal sphincter becomes lax and allows moderate to large amounts of acidic stomach contents to regurgitate (reflux) into the esophagus. This causes esophageal inflammation (esophagitis) and, sometimes, ulcerations, scarring (strictures), and a variety of non-gastrointestinal symptoms, such as a chronic cough and asthma.

Traditional approaches to treatment

Before we explore the pros and cons of incisionless surgery for GERD, here’s a quick review of traditional approaches to the treatment of the disease.

Lifestyle changes

Some people with GERD can control their symptoms with lifestyle changes, such as avoiding fried foods, alcohol, not going to sleep right after a big meal or losing weight. However, many will resort to medications — often proton pump inhibitors or PPIs.


Although prescription or over-the-counter PPIs are often taken for very long periods of time, significant risks related to taking the medication for longer than it was originally intended have been reported in the medical literature. These include (amongst others):

  • Increased risk of C.difficile[ii]
  • Chronic kidney disease[iii]
  • Cardiovascular disease[iv]
  • Increased risk of osteoporosis fractures[v]
  • Dementia[vi]
  • Stroke[vii]


Surgical correction of a lax LES has been an accepted alternative to treat chronic GERD for many years. However, whether done by an open procedure (Nissen fundoplication) or by laparoscopy (laparoscopic Nissen fundoplication), it is a big operation that may leave patients with some unpleasant symptoms, such the inability to belch or vomit, difficulty swallowing, bloating, and an increase in flatulence.

A Non-Medication, Non-Surgical Incisionless Alternative

I recently met with Skip Baldino, the President, and CEO of EndoGastric Solutions. I wanted to learn about his company’s innovative non-medication, non-surgical incisionless alternative for the treatment of GERD. According to their literature, the company is “a medical device company focused on developing and commercializing innovative, evidence-based, non-invasive surgical technology for the treatment of GERD.”

What is a fundoplication?

Fundoplication is a surgical procedure that involves wrapping and then sewing the upper part of the stomach (called the fundus) around the lower esophagus in a way that causes the esophagus to pass through a small tunnel created out of stomach muscle. This strengthens the lax LES and makes it more difficult for acidic stomach contents to back up into the esophagus.

Dr. Patricia Salber and friends weigh in on leading news in health and healthcare

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store