The trans-oral Stretta catheter system uses a proprietary application of RF energy that is low-power (5 Watts) and generates low temperatures (65°C to 85°C) during a series of 14 one-minute cycles which remodel the lower esophageal sphincter (LES) muscle and gastric cardia. The FDA originally cleared Stretta for use in 2000 and issued an updated clearance on the RF1 generator in 2011. Clinical studies demonstrate that Stretta RF treatment results in significant reductions in tissue compliance and transient LES relaxations, as well as increased LES wall thickness due to muscle growth. These mechanisms restore the natural barrier function of the LES and reduce spontaneous regurgitation caused by transient relaxations of the sphincter, two of the leading causes of GERD. Stretta is typically performed on an outpatient basis with conscious sedation.
Quality of Evidence: (++++)
Grade Recommendation: Strong
The Society of American Gastrointestinal and Endoscopic Surgeons recently issued Clinical Guidelines that gave Stretta therapy for the treatment of GERD the highest GRADE recommendation. The SAGES Clinical Spotlight Review involved an in-depth analysis of available peer-reviewed clinical evidence, focusing on randomized, controlled studies, as well as long-term follow up showing durability of treatment effect.