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Surgery without incisions for chronic heartburn, reflux first in county

‘Incisionless surgery’ means no pills, no scars

February 25, 2011
Special To The Citizen

Doctors Martin Barrios and Peter M. Denk are the first laparoscopic and "incisionless" general and bariatric surgeons in Lee County to perform a trans-oral (through the mouth) procedure for acid reflux called the TIF (Trans-oral Incisionless Fundoplication) procedure.

They have offices in Lehigh Acres and work out of Lehigh Regional Medical Center.

"The TIF procedure can significantly improve quality of life for our patients," Barrios said.

Article Photos

Surgeons: Dr. Peter Denk, left, and Dr. Martin Barrios

"Gastro esophageal Reflux Disease or GERD is an anatomical problem which needs an anatomical solution. Reflux medication like PPIs (proton pump inhibitors) can help relieve patients' heartburn symptoms but don't solve the underlying anatomical problems. Even on PPIs many patients are still unable to eat the foods they want or have to sleep sitting up," he said.

In addition recent studies have shown that long-term use of PPIs can lead to inadequate absorption of minerals such as calcium and can result in bone fractures.

After the TIF procedure, clinical trials show that most patients can eat and drink foods they avoided for many years. Reflux no longer impacts their life like it previously did, Barrios said.

The TIF procedure is based on established principles of surgical repair of the antireflux barrier, except that it is "surgery from within" performed trans-orally.

The procedure repairs the valve between the stomach and esophagus restoring the natural, physiological anatomy to prevent reflux. Because the procedure is incisionless, there is reduced pain, reduced recovery time and no visible scar, Barrios said.

The TIF procedure is part of a revolutionary new way of performing surgery termed "incisionless surgery."

"Incisionless surgery is the next step in the evolution of surgery to less and less invasive techniques. It uses the body's natural orifices such as the mouth to allow surgeons access to the abdomen," Denk added.

With millions of Americans suffering with daily symptoms of reflux and many not fully satisfied with their current treatment therapy, TIF offers an excellent alternative.

"Recent studies show that TIF can reduce patients' dependency on medications with 79 percent of patients remaining off their daily medications after two years and experiencing a dramatic improvement in their quality of life," Denk pointed out.

Barrios and Denk offer the latest in minimally invasive surgical treatment for gastrointestinal disease and weight-loss surgery in Southwest Florida, according to officials at Lehigh Regional Medical Center.

They are both national and regional leaders, having performed many "firsts" from advanced laparoscopic, to single-incision, to incisionless procedures, LRMC officials said.

Barrios joined LRMC in 2009 and has become a leader in single-incision laparoscopic abdominal surgery in the Fort Myers greater area. GI diseases he has treated with single incision laparoscopic surgery include gallbladder, appendix, hernia, acid reflux problems, stomach, and colon problems including cancer.

Barrios says he has found patients recover faster, have better cosmetic results, and have less pain from single-incision surgery.

He also performed the first Incisionless ROSE (Repair of Surgery, Endolumenal) for weight-regain following gastric bypass in Southwest Florida in December of 2009.

Denk performed the first Incisionless POSE (Primary Obesity Surgery, Endolumenal) in the United States in February of 2009. Denk was part of the team of surgeons that performed the first NOTES Transgastric Natural Orifice Cholecystectomy (Incisionless gallbladder removal through the mouth) in the United States in May of 2007.

Building on the experience of incisionless gallbladder surgery with decreased patient post-operative pain and faster recovery, Denk helped develop incisionless treatments for obesity, LRMC officials said. He has extensive experience with the ROSE procedure and has taught nearly all surgeons performing ROSE today, officials said. Their offices are located at 1530 Lee Blvd., Suite 1100, in the building next to the hospital.



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