A medical program chairperson always can be sure of a lively discussion by scheduling a panel on "The Best Way to Treat Gastroesophageal Reflux." With the addition now of one more approach—a horseshoe— shaped silicone prosthesis for the esophagus—those discussions should be all the livelier.
The device, measuring about 3 cm at its widest inner diameter and 7 cm at its greatest outside diameter, encircles the esophagus below the diaphragm. So far, say two Arizona surgeons in the latest report (Surg Gynecol Obstet 148:246-248, 1979), the prosthesis has prevented recurrence of sliding esophageal hiatal hernia or symptoms of gastroesophageal reflux in 44 patients since May 1973. Placed just adjacent to the sphincter, it apparently augments the somewhat lax tone of that anatomic area.
Jean-Pierre Angelchik, MD, who developed the device, and Rafael Cohen, MD, from the surgery departments of Baptist and John C. Lincoln hospitals, Phoenix, first make an upper