ASGE DDW Videos from Around the World | 2026-THE RESECTION AND PLICATION (RAP) TECHNIQUE FOR GASTROESOPHAGEAL REFLUX DISEASE

THE RESECTION AND PLICATION (RAP) TECHNIQUE FOR GASTROESOPHAGEAL REFLUX DISEASE

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Video Summary

A 28-year-old woman with eosinophilic esophagitis had refractory GERD despite maximal PPI therapy. Endoscopy showed erosive esophagitis and a small hiatal hernia; TIF failed because of fibrosis. She then underwent a novel resection and placation endoscopic antireflux reconstruction: mucosal resection around the gastroesophageal junction was performed to promote fibrosis, followed by argon plasma coagulation, hemostatic gel, and endoscopic suturing to tighten and wrap the junction. The procedure improved the valve to Hill grade I, and six-month follow-up showed durable results. This technique may offer a minimally invasive option for complex GERD cases.

Asset Subtitle

Submitted by Steven Steinway

Keywords

eosinophilic esophagitis

refractory GERD

endoscopic antireflux reconstruction

gastroesophageal junction

hiatal hernia