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HALO ablation for Barrett's Esophagus

HALO ablation is an advanced endoscopic technique using radio frequency ablation (RFA) that is being widely employed for treating Barrett’s Esophagus. The technique is characterized by complete removal of the damaged esophageal tissues with specific and controlled heat radiation, without affecting the surrounding normal tissues in the throat. It is a non-invasive technique and usually the patient is discharged on the same day of the operation.
 
Barrett’s esophagus is a precancerous condition that affects the lining of the esophagus due to gastric disorders such as gastro esophageal reflux disease (GERD) or heartburn. GERD is a gastric problem in which there is backflow of acid and bile from the stomach, into the esophagus region. This may cause injury and inflammation of the cells lining the esophagus. The untreated GERD or prolonged and continued acid exposure to the walls of the esophagus, may induce mutation (genetic) changes in the esophagus cells. This results in conversation of normal-sized cells into abnormal taller columnar cells, called Barrett’s cells and the condition is known as Barrett’s esophagus.

Various clinical studies revealed that patients with Barrett’s esophagus are more prone to esophageal cancer.  In addition, other risk factors for developing esophageal cancer include excessive consumption of tobacco and alcohol.

Barrett’s esophagus can be diagnosed through medical history that involves analyzing the severity and duration of GERD symptoms. It is followed by endoscopy that involves visual analysis and tissue sampling of the affected areas of the esophagus.

The HALO procedure first involves the visual examination of the esophagus with the help of a tube-shaped device with attached camera, called an endoscope. Next, a catheter is inserted through the endoscope into the mouth and a specially-designed balloon is expanded to fill the esophagus and provide uniform tension of the esophageal lining. Then, the HALO system generates a short burst of energy to remove a thin layer of diseased tissue lining the esophagus. The balloon is repositioned until all areas of the esophagus are treated.  Finally the devices are taken out of the mouth with the whole procedure taking about 30-60 minutes to complete. The replacement of the treated damaged layer of cells with new healthy tissue takes about 3-4 weeks. A follow up endoscopy is usually scheduled a few months later to ensure all areas have been effectively treated.   A second HALO treatment may be given at this time if areas of Barrett's esophagus remain.

The basic advantages of HALO intervention include circumferential or focal treatment options that remove only the diseased cells of the esophagus, lack of severe adverse effects such as narrowing of the esophagus and the procedure does not adversely affect the functioning of the associated glands.
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