procedure-tutorial

Procedure Tutorial

How does the balloon-mounted ablation system work?

  • A sizing balloon is inserted into your esophagus to measure its diameter.
  • A correctly sized ablation balloon is then inserted and inflated close to the Barrett's tissue.
  • A rapid burst of radiofrequency energy (less than one second) heats and removes a very thin layer of the diseased esophagus (less than one millimeter).
  • The tissue removal is tightly controlled with the intent to minimize unintended injury to underlying healthy tissue.
  • Following the treatment, new esophageal tissue grows in three to four weeks for most patients, according to trial results.
  • The procedure is performed without incisions using conscious sedation in an outpatient setting.
  • The procedure takes about 25 minutes.
  • Some people may have some minor discomfort, which was managed with medication in clinical trials.
  • Following the treatment, your physician will prescribe potent acid suppression medication to prevent damage to the new tissue.

How does the endoscope-mounted ablation system work?

  • Using an endoscope, the physician directs the electrode to the diseased area of your esophagus.
  • A short burst of radiofrequency energy (less than one second) heats and removes a very thin layer of the diseased esophagus (less than one millimeter).
  • The procedure takes about 15 minutes and is performed without incisions using conscious sedation in an outpatient setting.
  • Following the treatment
    • new tissue grows in three to four weeks for most patients, according to trial results
    • your physician will prescribe potent acid suppression medication to prevent damage to the new tissue

Contraindications

RFA is contraindicated in patients who:

  • are pregnant
  • have had prior radiation therapy to the esophagus
  • have esophageal varices at risk for bleeding [varices are large blood vessels along the inner wall of the esophagus seen in patients with liver disease]
  • had prior Heller myotomy [a surgery in which the muscular valve (the lower esophageal sphincter) in between the esophagus and the stomach is repaired to allow food and liquids to pass more easily into the stomach].
  • have eosinophilic esophagitis [an inflammatory condition of the wall of the esophagus]

Possible complications

RFA has demonstrated an outstanding safety profile with a stricture rate (narrowing of the esophagus) less than or equal to 6%**, less than 0.02% perforation rate, and no associated deaths14 (based on safety data through June 2010). There are possible risks of complications which may include:

  • mucosal laceration [a partial thickness tear of the wall of the esophagus];
  • perforation of the stomach, esophagus or pharynx;
  • endoscopic clipping to manage mucosal laceration or bleeding;
  • surgery to correct and manage perforation;
  • infection;
  • minor acute bleeding;
  • major bleeding;
  • cardiac arrhythmia;
  • pleural effusion;
  • narrowing of the esophagus requiring dilation;
  • transfusion secondary to major bleeding;
  • aspiration;
  • death

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