No More Reflux

Knoxville woman’s GERD relieved by robotic-assisted surgery at Fort Sanders Regional

For Caitlin Peterson of Knoxville, 32, eating had become nearly impossible last year. She suffered from severe gastroesophageal reflux disease (GERD), and threw up every day.

“I lost almost 90 pounds,” she said. “I was vomiting multiple times a day and my body was rejecting meat. I was pretty much eating pizza and ice cream and that was it,” said Peterson. “It was not an eating disorder. People could see I was physically trying to eat, and it would come back up.”

Peterson’s GERD was caused by a severe hiatal hernia. This occurs when the upper part of the stomach bulges through the opening (called the hiatus) in the diaphragm, a large muscle that separates the abdomen and chest cavities.

A small hiatal hernia isn’t usually a problem, but a large one can let food flow back up into the esophagus, leading to heartburn, reflux, vomiting and chest pain.

“I had the hernia and a lot of reflux for over 10 years, but it had always been smaller,” said Peterson. With time and the usual strains of life from coughing, having a bowel movement or vomiting, it had enlarged. “Also, I have always thrown up a lot. I learned at a young age how to deal with it. I always know where the bathrooms are,” she said.

Anxious for relief, in March 2023 Peterson went to see Michael Antiporda, MD, who is fellowship-trained in minimally invasive esophageal and stomach surgery. He conducted several tests to confirm her diagnosis of hiatal hernia and GERD, and evaluate the overall function of her esophagus and stomach. The tests also helped him determine the best anti-reflux operation for her particular case.

“I’m glad I went through the testing because it led to a different type of surgery,” Peterson said. “I had the TIF procedure. I’m an IT manager, so I love the idea of having a type of surgery that’s the latest and greatest in technology.”

Transoral Incisionless Fundoplication (TIF) is a reconstruction of the valve between the stomach and the esophagus using an endoscope and without extra incisions. The procedure is done through the mouth and esophagus. The top tissues of the stomach (the fundus) are used to re-create a valve by folding the tissue over and essentially wrapping it around the esophagus in a uniform and ideal fashion.

At Fort Sanders Regional Medical Center, Dr. Antiporda used a state-of-the-art robotic surgical suite to perform Peterson’s surgery.

While viewing 3D, high-resolution images on a computer screen, Dr. Antiporda used microsurgical instruments powered by robotic arm technology. “For Caitlin, we took advantage of the most technologically advanced procedures available,” he said. “We were able to conduct a minimally invasive procedure to construct an anti-reflux valve for her that is more uniform and better able to consistently stop her reflux.”

Peterson spent one night at the hospital and went back to her work-from-home job as an IT project manager after just one day off work.

“My experience at Fort Sanders Regional was great,” she said. “Everyone was very nice. They want you to feel comfortable. My dad took me to the hospital, and he couldn’t believe how fast it all was.”

Recovery involved a month of liquid foods before Peterson could swallow well again. She also had a follow-up noninvasive procedure in July to adjust the tightness of her new valve, a step that is occasionally performed after definitive anti-reflux surgery.

“But ever since then everything’s been perfect,” she said. “I’ve gained 15 pounds back. I feel like I have more energy, and I’ve got a good sleep schedule now. It definitely has affected my life! I’m not afraid to go out to eat because I might get sick. I’m not afraid to do a long road trip.”

Dr. Antiporda stressed that persistent GERD should always be evaluated thoroughly. “The most important thing is to meet with a specialist with extensive experience treating conditions of the esophagus or stomach, either a gastroenterologist or a foregut surgeon, because treatment can be complex,” he said. (A foregut surgeon specializes in the anterior part of the digestive tract.)

“There are options besides pills that are extremely effective for treating GERD. If we don’t treat it, reflux can increase the chances of esophageal cancer. There are many options for such treatments at Fort Sanders Regional.”

Peterson said she would recommend Fort Sanders Regional and Dr. Antiporda to anyone who needs a similar surgery. “He spends time with you. He truly cares for his patients.

“I’m very happy with everything Dr. Antiporda did for me, and everyone at Fort Sanders Regional was super nice. It was great care. Now I’m able to eat anything I want, as often as I want!”