Interventional procedure overview of laparoscopic insertion of an inactive implant for gastro-oesophageal reflux disease

Indications and current treatment

Gastro-oesophageal reflux disease (GORD) is when stomach acid and other contents flow back (reflux) into the oesophagus (food pipe). This can cause symptoms such as heartburn, chest pain, hoarseness, difficult swallowing, cough, wheezing and dental erosions, and can impair quality of life. GORD can occur when the lower oesophageal sphincter (LOS, the ring of muscle at the bottom of the oesophagus) does not work properly, or if the LOS moves above the diaphragm into the thoracic cavity. In some cases, part of the top of the stomach (the fundus) can also push up through the diaphragm. This is called a hiatus hernia (HH).

The standard treatments for symptomatic GORD are lifestyle modification and drug therapy. If these do not work or are not appropriate, people could be offered surgery. One option is laparoscopic insertion of a magnetic ring at the gastro-oesophageal junction (see NICE's interventional procedures guidance). Another surgical option is laparoscopic fundoplication, a procedure that involves wrapping the top part of the stomach around the lower oesophagus (see NICE's guideline on the investigation and management of gastro-oesophageal reflux disease and dyspepsia). For those with more complex cases, such as GORD with oesophageal motility disorders, there are limited treatment options.