I have been doing Anti Reflux Mucosal Ablation (ARMA) for GERD for a while now and I have to say the results have been impressive! Are you doing this in your practice? #arma #gitwitter #gerd #esophagus #surgery

Great results, congrats! 👏 Curious about your protocol: APC settings (W/flow)? Ideal candidates? Timing of follow-up and symptom improvement? Ablation extent (% circumference)? Post-ARMA dysphagia rate? Thanks!👊🏽👊🏽

I do ARBM mostly for Hill I & II. Quicker and cost effective. Though I’m sure ARMA will have better results considering the larger expanse of mucosa that it covers. Which now has me wondering…should I apply another line of bands to increase mucosal coverage 🤔

There appears to be a wrap in place . Failed wrap ?

Loose fundoplication.

May be worth publishing your experience in those with a wrap and no recurrent hernia (as in this video). There is some evidence for tif in this scenario but not sure about ARMA/ARMA

We have done a few s/p fundoplication where the wrap was loose.

I'm having a weak lower esophageal sphincter. Since about 35 years i take medication every day to reduce the acid in my stomach. Is this repairable through surgery?

What settings are used ? Forced/pulse/precise APC?

How many french is this APC probe ?

6.9

Excellent. What is the selection criteria for ARMA? Your settings ? Protocol ? Results ?

これは瘢痕形成を利用して噴門部の形成を行ってるのですか？

Is it the later contracted scar that helps?

Yes

Excellent innovation

This approach reminds me of this headache treatment. I hope in the future, when we look back, you will appreciate how barbaric our medicine was still despite all the advancements 🙂

Con que tipo de energía?

Where can someone learn the procedure? Or is this something Like „learning by doing“

Very selectively for patients with Hill Grade 2 or less hiatus hernia and unfit for fundoplication. Cautious now after doing it for several years, based on the most recent RCT.

The wrap looks tight. How will ARMA work here sir?

Wrap was loose

Thankyou