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Pursuit of endoscopic techniques for treatment of gastroesophageal reflux disease (GERD) -- such as delivery of an implantable material or device around the lower esophageal sphincter (LES) -- dates back to the 1980s with the use of bovine collagen and Teflon paste. In 2003, the FDA approved a nonbiodegradable, bioinert polymer (Enteryx; Boston Scientific, Natick, MA). More recently, insertion of implantable hydrogel prostheses (Gatekeeper; Medtronic, Minneapolis, MN) into the esophageal mucosa above and below the LES has been shown to be safe and effective for reducing reflux symptoms. In a 6-month prospective nonblinded study, researchers in Italy evaluated the effect of the Gatekeeper procedure in nine patients with uncomplicated GERD.
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