When medications aren't enough to control the unpleasant symptoms of heartburn and acid reflux, surgery is sometimes necessary. A new procedure done with no incisions is being promoted as an alternative to conventional surgery, the Wall Street Journal reported.

Traditional heartburn surgery involves tiny incisions in the abdomen, through which surgical tools are inserted and a new valve is created that prevents stomach contents from rising up. In the new procedure, the valve is created by inserting a surgical device that looks like a toy fishing pole into the mouth and snaking it down the throat to where the esophagus meets the stomach. The device is sold by EndoGastric Solutions Inc., of Redwood City, Calif.

"It's not as aggressive a procedure" as traditional surgery but it isn't as effective based on patient satisfaction and elimination of acid in the esophagus, said Dr. Hiran Fernando, chief of thoracic surgery at Boston Medical Center. The upside is that the new technique has fewer longterm side effects, including bloating, said Fernando, who performs both types of procedures.

So far, most studies on the new procedure have followed patients for six months or a year afterward. "We honestly don't know what the efficacy is going to be long term," said Dr. Reginald Bell, a surgeon in Englewood, Colo., who occasionally serves as a paid consultant to Endogastric Solutions. The procedure typically costs $6,000 to $14,000; some insurers cover it, but many still consider it experimental.

Frequent heartburn or acid reflux are symptoms of a condition called GERD, or gastroesophageal reflux disease, which occurs when a sphincter muscle in the lower esophagus stops working properly. Some 20 percent of Americans experience symptoms of reflux of stomach contents at least weekly, including a burning sensation in the chest or throat or regurgitation, according to the National Institutes of Health.

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