Cutting-edge endoscopic treatment for GERD

The development of endoscopic treatment for GERD is not only a dream for endoscopists but also holds great expectations from patients. Over many years, various techniques have been reported, but most of them have had issues with long-term results. Recently developed methods such as ARMS and ESD-G feature the unique characteristic of "inducing ulcer scarring by resecting the mucosa," which has resulted in relatively long-term efficacy by using non-expensive equipment.
We reported the first case in 2003 and introduced ARMS in 2014. Simultaneously, ESD-G was also reported. Subsequently, ARMS evolved into ARMA. At this point, three systematic reviews and meta-analyses reported the safety and efficacy of ARMS/ARMA.
Although ARMS/ARMA are simple and effective techniques, there are individual differences in the contraction rate of artificial ulcers. To address this, we devised the mucosal resection method where the mucosal defect is closed in one stage during the initial mucosal resection (fundic mucosal formation surgery). This technique is known as ARMP. There are methods using Clip (Mantis) and methods using Suture (SutuART). The key point here is to place a tension-relief incision[8] during the mucosal incision. This has led to stable results. We will present the actual results of ARMP/C (Anti-reflux mucosal plasty with counter mucosal incision).
"Endoscopic treatment for gastroesophageal reflux disease" is becoming the standard treatment for patients with refractory GERD.