Endoscopic anti-reflux mucosal surgery (ARMS) for reflux esophagitis

Endoscopic anti-reflux mucosal surgery (ARMS) for reflux esophagitis

At Tane General Hospital, we are always striving to introduce the most advanced treatment methods for the health of our patients and to provide high quality medical services.
The Department of Gastroenterology has recently introduced endoscopic anti-reflux mucosal surgery (ARMS) for patients with reflux esophagitis (covered by insurance).
In particular, we aim to achieve faster results and reduce the risk of complications by incorporating endoscopic anti-reflux mucous membrane plication (ARMP), which is a type of ARMS.

ARMS is an innovative non-surgical treatment for refractory gastroesophageal reflux disease (GERD, including reflux esophagitis). This treatment is suitable for patients whose symptoms have not improved with treatment that strongly suppresses gastric acid secretion, such as PPIs and PCABs, or who are concerned about the risk of side effects from taking these medicines for a long time.

What kind of treatment is endoscopic anti-reflux mucosectomy (ARMS)?

ARMS is a technique that uses a gastroscope to remove a portion of the mucosa at the esophago-gastric junction (EGJ) and then reshape the mucosa to improve the looseness of the EGJ, which causes gastric reflux, and prevent reflux. Unlike laparotomy or endoscopic surgery, this procedure does not cause any scarring on the body surface because it can be completed using only an endoscope. In addition, since the procedure is performed under sedation, the patient sleeps and is not in pain during the procedure.

Conventional non-pharmacologic treatment for GERD is laparoscopic Nissen surgery. Traditionally, there has been a division between patients with reflux esophagitis who can be controlled with PPI/PCAB and those who require the Nissen procedure. However, with the advent of ARMS, many of those who need Nissen surgery can now be treated with this minimally invasive endoscopic procedure, which is as effective as Nissen surgery in terms of short- and long-term improvement of reflux symptoms and quality of life (QOL). Furthermore, ARMS is a minimally invasive endoscopic procedure that offers the following advantages over surgery.

• Treatment can be performed without creating any wounds on the body surface
• Short treatment time
• Short hospitalization period
• Almost no pain after treatment
• Fast return to daily life and work

References：
Surg Endosc. 2021 Dec;35(12):7174-718
2Surg Endosc. 2023 May;37(5):3944-3951.

Patients for whom ARMS(ARMP) is indicated

ARMP offers new hope for GERD patients who are constantly experiencing the pain of symptoms and continued medication in their daily lives. Our specialists will carefully evaluate each patient’s condition and recommend the most appropriate treatment.

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