Radiofrequency Ablation

Radiofrequency ablation (RFA, the “HALO” procedure) is an endoscopic treatment for the eradication of BE. Barrett's esophagus (BE) with dysplasia (precancer). The procedure is performed during a routine upper endoscopy amd requires 3-4 treatment sessions (on average) of which each treatment is about 30-45 minutes. Studies suggest that this ablation technique is highly effective in removing Barrett's mucosa and associated dysplasia and in preventing progression of disease, while minimizing the drawbacks of other treatments such as photodynamic therapy and argon plasma coagulation which include stricture (narrowing) and buried Barrett’s.

Barrett’s esophagus occurs when an abnormal, intestinal-type epithelium called "specialized intestinal metaplasia" replaces the stratified squamous epithelium that normally lines the distal esophagus. The condition develops as a consequence of chronic gastroesophageal reflux disease and predisposes to the development of adenocarcinoma of the esophagus.

Traditionally, high-grade dysplasia and intramucosal cancer arising from BE were treated with esophagectomy, while non-dysplastic BE and BE with low-grade dysplasia were managed with endoscopic surveillance. Problems associated with these approaches included significant morbidity and mortality from esophagectomy, and the risk of missed or interval development of cancer in patients undergoing surveillance. To address these issues, less invasive endoscopic treatments have been developed including radiofrequency ablation.