Overview of current endoscopic therapies
| Device/technique | Advantage | Disadvantage | Reported adverse events |
| Stretta Radiofrequency | Single operator Does not preclude future antireflux surgery Good safety profile | Limited mechanistic data Heterogeneous evidence base with variable response rates Limited improvement in physiological parameters Requires proprietary equipment | Chest pain Erosive oesophagitis Gastroparesis |
| EsophyX Z+ Plication | Does not preclude future anti-reflux surgery Can be revised if required Being evaluated as an option for concomitant laparoscopic HH repair (C-TIF) for larger HH | Two operator technique Requires proprietary equipment Large calibre device can make oesophageal intubation difficult | Pneumothorax Perforation Bleeding |
| GERD-X Plication | Relatively short operating time36 Faster learning curve36 | Two operator technique Requires proprietary equipment Limited long-term data | Chest pain |
| ARMS Mucosal resection | Does not require proprietary equipment Can be conducted without General anaesthetic (GA) | Steep learning curve High risk of perforation and bleeding Non standardised technique | Dysphagia Bleeding Perforation |
| ARMA Ablation | Does not require expensive proprietary equipment Less technical than ARMS Can be performed without GA | Relatively new technique with limited evidence base Non standardised technique | Dysphagia |
| PECC/ARBM Ligation | Uses a technique and equipment that most gastroenterologists are well versed with Shorter procedure time Less technically challenging | Limited data Non standardised technique | Retrosternal discomfort Dysphagia |
| MASE/RAP Suturing | Trialled in patients with altered anatomy post-surgery | Limited evidence base Non-standardised technique Steep learning curve Requires proprietary equipment | Dysphagia |
ARBM, antireflux band mucosectomy; ARMA, antireflux mucosal ablation; ARMS, antireflux mucosectomy; c-TIF, concomitant transoral incisionless fundoplication; MASE, mucosal ablation and suturing at the esophagogastric; PECC, peroral endoscopic cardial constriction; RAP, resection and plication.