ORBERA Balloon System

ORBERA PlacedORBERA is a reversible, non-surgical weight loss procedure, which means no incisions, stitches, or scars. The deflated balloon is placed in the stomach while the patient is under a mild sedative. The balloon is filled with saline until it’s about grapefruit size. It takes just 20-30 minutes and most people go home the same day.

The balloon is in place only temporarily, as opposed to permanent surgical alterations. After six months, the balloon will be removed through a quick non-surgical procedure while the patient is under mild-sedative. Most patients lose 3.1x the weight typical with diet and exercise alone.

Stretta Procedure

Stretta therapy is a minimally invasive procedure that significantly reduces GERD symptoms, allowing the majority of patients to eliminate or largely decrease use of PPIs. Stretta is an outpatient procedure performed in less than 60 minutes, allowing patients to return to normal activities the following day. Stretta doesn’t require any incisions, stitches or implants.

How Stretta Works

The Stretta system delivers radiofrequency (RF) energy to the muscle between the stomach and esophagus, which remodels and improves the muscle tissue, resulting in improved barrier function and fewer reflux events. Stretta treats the underlying problem that may cause GERD without surgery.

Click here to view a video of the procedure


TIF procedure with EsophyX Z device

Transoral Incisionless Fundoplication (TIF) is a procedure for reflux. It is performed without the need for external incisions through the skin, the TIF procedure offers patients who require an anatomical repair another treatment option to correct the underlying cause of GERD. Studies show that for up to three years after the TIF procedure esophageal inflammation (esophagitis) is eliminated and most patients are able to stop using daily PPI medications to control symptoms.

Click here to view a video of the procedure

Barium Swallow X-Ray

A barium swallow is a test that may be used to determine the cause of painful swallowing, difficulty with swallowing, abdominal pain, bloodstained vomit, or unexplained weight loss.

Barium sulfate is a metallic compound that shows up on X-rays and is used to help see abnormalities in the esophagus and stomach. When taking the test, you drink a preparation containing this solution. The X-rays track its path through your digestive system.

These problems can be detected with a barium swallow:

  • Narrowing or irritation of the esophagus (for example, Schatski's ring)
  • Disorders of swallowing (dysphagia - difficulty swallowing), spasms of the esophagus or pharynx
  • Hiatal hernia (an internal defect that causes the stomach to slide partially into the chest)
  • Abnormally enlarged veins in the esophagus (varices) that cause bleeding
  • Ulcers
  • Tumors
  • Polyps (growths that are usually not cancerous, but develop into cancer)
  • Gastroesophageal reflux disease (GERD)

Click here for more information about the barium swallow test

Esophageal Motility Tracing (Manometry)

This is a specialized test to study the coordination or lack of activity of the esophageal muscle. It checks the pressure of the waves generated by the muscles in your food pipe. It also looks for disease that result in the sphincter muscles in esophagus relaxing too little (Achalasia) or being too weak (scleroderma). It can also diagnose spastic conditions of the esophagus that sometimes result in chest pain and mimic heart attacks.

Click here to view an example of motility tracing

Endoscopic Ultrasound

eusEndoscopic Ultrasound (EUS) combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs. Endoscopy refers to the procedure of inserting a long flexible tube via the mouth or the rectum to visualize the digestive tract (for further information, please visit the Colonoscopy and Flexible Sigmoidoscopy articles), whereas ultrasound uses high-frequency sound waves to produce images of the organs and structures inside the body such as esophagus, mediastinum, stomach, liver, gallbladder, pancreas, spleen aorta, rectum etc.

Traditional ultrasound sends sound waves to the organ(s) and back with a transducer placed on the skin overlying the organ(s) of interest, images obtained by traditional ultrasound are not always of high quality. In EUS, a small ultrasound transducer is installed on the tip of the endoscope. By inserting the endoscope into the upper or the lower digestive tract, one can obtain high quality ultrasound images of the organs inside the body. Tissue samples can also be obtained from these organs using a fine needle aspiration technique. Similar techniques can be used to deliver medications into or aspirate fluid from cysts.

What is the preparation for EUS?

We will want to know about your health status especially if you have any allergies or other significant health problems such as heart disease, lung disease, diabetes mellitus, or bleeding disorders etc. You will need to have an empty stomach (that means no oral intake for 6 or more hours). In the case of a rectal EUS, you will most likely be given enemas or laxatives. In either case, full instructions will be given to you.


Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to identify and remove stones, tumors, or bypass the narrowing in the bile ducts. The procedure is done through an endoscope. Abnormal results may indicate stones or narrowing of the ducts, presence of tumors, cancer, and cysts (abnormal cavity filled with fluid or semi-solid substances).


Barrax - Radiofrequency Ablation

Radiofrequency Ablation (RFA) therapy has been shown to be safe and effective for treating Barrett’s esophagus. Radiofrequency energy (radio waves) is delivered via a catheter to the esophagus to remove diseased tissue while minimizing injury to healthy esophagus tissue. This is called ablation, which is the removal or destruction of abnormal tissue.

While you are sedated, a device is inserted through the mouth into the esophagus and used to deliver a controlled level of energy and power to remove a thin layer of diseased tissue. Less than one second of energy removes tissue to a depth of about one millimeter. The ability to provide a controlled amount of heat to diseased tissue is one mechanism by which this therapy has a lower rate of complications than other forms of ablation therapy.