Method for treating gastro esophageal reflux disease
In an endoscopic treatment method, a damaged area is formed in at least a portion of a digestive tract along a circumferential direction. The damaged area is formed by performing thermal ablation of mucosal layer and not removing the mucosal layer. An incomplete stenosis is formed in the digestive tract during restoration of the damaged area.
1. An endoscopic treatment method comprising:
forming a damaged area in at least a portion of a digestive tract along a circumferential direction by performing thermal ablation while keeping a mucosal layer; and
forming an incomplete stenosis in the digestive tract, while restoring the damaged area,
wherein the damaged area is formed by causing damage to a mucosal base layer, the mucosal base layer having an interface that contacts a submucosal layer.
2. The endoscopic treatment method according to claim 1 , wherein
the digestive tract is a stomach;
the damaged area includes the mucosal layer of an inner wall of the stomach near a cardiac orifice;
a gap is provided between the damaged area and the cardiac orifice; and
the incomplete stenosis is formed around the cardiac orifice.
3. The endoscopic treatment method according to claim 2 , wherein
the damaged area is formed only in the portion along the circumferential direction of the stomach.
4. The endoscopic treatment method according to claim 3 , wherein
the damaged area includes:
an arcuate first area formed at an anterior wall of the stomach; and
an arcuate second area formed at a posterior wall of the stomach, wherein:
a first non-damaged area is positioned between the first area and the second area, and on a greater curvature side, the first non-damaged area being a first area where thermal ablation of the mucosal layer is not performed,
a second non-damaged area is positioned between the first area and the second area, and on a lesser curvature side, the second non-damaged area being a second area where thermal ablation of the mucosal layer is not performed, and
a dimension of the first non-damaged area in the circumferential direction is greater than a dimension of the second non-damaged area in the circumferential direction.
5. The endoscopic treatment method according to claim 2 , further comprising:
before performing thermal ablation of the mucosal layer,
observing a junction between the stomach and esophagus with an endoscope inserted into the stomach, and identifying a treatment area to form the damaged area; and
forming a marking on at least a portion of a periphery of the treatment area.
6. The endoscopic treatment method according to claim 5 , further comprising:
after forming the marking, infusing liquid into a submucosa of the treatment area to swell the treatment area.
7. The endoscopic treatment method according to claim 1 , further comprising:
observing a condition of the incomplete stenosis generated in the digestive tract and additionally performing thermal ablation of the mucosal layer according to a result of the observation.
8. The endoscopic treatment method according to claim 1 , wherein the mucosal layer is not excised.
9. An endoscopic treatment method comprising:
forming a damaged area in at least a portion of a digestive tract along a circumferential direction by performing thermal ablation while keeping a mucosal layer; and
forming an incomplete stenosis in the digestive tract, while restoring the damaged area,
wherein the digestive tract is a stomach,
the damaged area includes the mucosal layer of an inner wall of the stomach near a cardiac orifice,
the incomplete stenosis is formed around the cardiac orifice,
the damaged area includes:
an arcuate first area formed at an anterior wall of the stomach; and
an arcuate second area formed at a posterior wall of the stomach, wherein:
a first non-damaged area is positioned between the first area and the second area, and on a greater curvature side, the first non-damaged area being a first area where thermal ablation of the mucosal layer is not performed,
a second non-damaged area is positioned between the first area and the second area, and on a lesser curvature side, the second non-damaged area being a second area where thermal ablation of the mucosal layer is not performed, and
a dimension of the first non-damaged area in the circumferential direction is greater than a dimension of the second non-damaged area in the circumferential direction.
10. The endoscopic treatment method according to claim 9 , further comprising:
a first portion of at least one of the first area and the second area; and
a second portion of at least one of the first area and the second area,
wherein the first portion is closer to a greater curvature side than the second portion, and
thermal ablation of the first portion is performed before thermal ablation of the second portion.
11. The endoscopic treatment method according to claim 9 , wherein a gap is provided between the damaged area and the cardiac orifice.
12. The endoscopic treatment method according to claim 9 , wherein the damaged area is formed only in the portion along the circumferential direction of the stomach.
13. The endoscopic treatment method according to claim 9 , further comprising:
before performing thermal ablation of the mucosal layer:
observing a junction between the stomach and esophagus with an endoscope inserted into the stomach, and identifying a treatment area to form the damaged area; and
forming a marking on at least a portion of a periphery of the treatment area.
14. The endoscopic treatment method according to claim 13 , further comprising:
after forming the marking, infusing liquid into a submucosa of the treatment area to swell and lift up the treatment area.
15. The endoscopic treatment method according to claim 9 , further comprising:
observing a condition of the incomplete stenosis generated in the digestive tract and additionally performing thermal ablation of the mucosal layer according to a result of the observation.