June 2005

 Emory Surgeons 1st in GA to Treat Barrett's Esophagus with Ablation

Surgeons from the division of general and gastrointestinal surgery were the first in Georgia, and among the first in the nation, to successfully treat a patient suffering from Barrett's esophagus with the FDA-approved Halo360 system, a device that uses bursts of radiofrequency energy to remove abnormal tissue without damaging healthy tissue.
Barrett's esophagus is a precancerous condition caused when chronic gastroesophageal reflux disease (GERD) damages the lining of the esophagus. Left untreated, Barrett's esophagus can lead to a esophageal adenocarcinoma, which has a five-year patient survival rate of just 16 percent. Traditionally, treatment options had been limited, especially since standard ablation techniques were unable to uniformly treat the esophageal lining, resulting in either excessively deep ablation that damaged healthy tissue or shallow treatment that only allowed the Barrett's cells to be covered up by new tissue growth. In addition, many of the ablation devices required very high operator skill.

As an endoscopic tool that provides uniform and controlled ablative therapy at a consistent depth, the Halo360 system can remove Barrett's cells and allow the re-growth of normal cells. It also provides preset sizing and fixed energy capabilities, allowing physicians to effectively treat patients without injuring healthy underlying tissue and thereby reducing the risk of complications normally associated with other forms of ablation therapy. C. Daniel Smith, MD, and his team were instrumental in the progress of the Halo360 system, leading a clinical trial to determine the optimal treatment parameters for the ablation of high-grade abnormal tissue cells found in Barrett's esophagus.

Performed without incisions using conscious sedation in an out-patient setting, the procedure involves using a Halo360 sizing balloon catheter to dilate the esophagus to determine its inner diameter, after which a correctly sized ablation catheter is inflated within the diseased area. Controlled delivery of energy avoids injury to normal, healthy underlying tissues. According to trial results, new healthy tissue replaced the ablated Barrett's tissue in three to four weeks for most patients. Minor discomfort, which may be experienced by some patients, was managed in the trials with medication. Following ablation therapy, patients resume acid suppression therapy.

The device was cleared by the U.S. Food and Drug Administration in 2001 and became commercially available in January 2005.

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