What is Halo Ablation for Barrett’s Esophagus?
HALO radiofrequency ablation (RFA) or HALO ablation is a nonsurgical treatment option for patients with Barrett's esophagus, a potentially serious condition in which the lining of the esophagus is replaced by tissue that is similar to the lining of the intestine through a process called intestinal metaplasia. In many instances, this change in tissue is triggered by gastroesophageal reflux disease (GERD). The esophagus or food pipe is a tube that connects the mouth to the stomach. It allows food and liquids to pass through it down to the stomach.
Performed in conjunction with an upper endoscopy, HALO ablation is a technique in which the diseased or pre-cancerous tissue in the esophagus is removed or ablated (destroyed) using heat energy in a highly controlled manner. Clinical studies have demonstrated that Barrett’s tissue can be completely eliminated with the HALO ablation technology in 98.4% of patients with minimal side effects.
Indications for Halo Ablation for Barrett’s Esophagus
Halo ablation is indicated for the treatment of Barrett’s esophagus when other conservative treatment measures such as medications and lifestyle changes have failed to treat Barrett’s esophagus.
Left untreated, Barrett’s esophagus can advance into a precancerous condition called dysplasia, an immediate precursor to esophageal cancer. Your doctor may recommend HALO if you have dysplasia or a family history of esophageal cancer from Barrett’s esophagus. HALO ablation can prevent damaged, abnormal cells from developing into cancer and allow healthy cells to replace them.
Preparation for Halo Ablation for Barrett’s Esophagus
Pre-procedure preparation for HALO ablation for Barrett’s esophagus may involve the following steps:
- A review of your medical history and a physical examination is performed to check for any medical issues that need to be addressed prior to the procedure.
- Routine laboratory tests such as blood work and urinalysis and diagnostic imaging such as X-rays and scans to help detect any abnormalities that could compromise the safety of the procedure and to formulate a preoperative plan for the procedure.
- You will be asked if you have allergies to medications, anesthesia, or latex.
- You should disclose information about your previous and current illnesses, possible allergic reactions, your current medications and supplements, smoking history, etc.
- Blood thinners or anticoagulant medications, such as aspirin will need to be stopped a few days prior to the procedure.
- You should not consume any solids or liquids at least 6 hours prior to the procedure.
- Arrange for someone to drive you home after the procedure, as you may feel groggy due to the effects of anesthesia/sedative medicines.
- A signed informed consent form is required from you after the procedure has been explained in detail.
Procedure for Halo Ablation for Barrett’s Esophagus
HALO ablation procedure is performed in combination with an upper endoscopy in an outpatient setting and takes about 45 minutes. In general, the procedure involves the following steps:
- You will be placed on the procedure table in a position that provides the best angle for your physician to conduct the procedure.
- General or local anesthesia is administered to numb your throat. You may also be given sedation medicine to keep you relaxed.
- A mouth guard will be placed to protect your teeth and gums.
- An upper endoscopy is performed where an endoscope - a thin flexible tube with a powerful light source and camera on the end - is inserted through your mouth and passed into the stomach for magnified viewing of the lining of the esophagus, stomach, and duodenum (upper part of the intestine).
- Once the abnormal Barrett’s tissue is identified, the HALO ablation catheter is inserted through the endoscope to deliver precise and controlled dosages of radiofrequency waves to destroy the thin Barrett’s esophageal tissue until it is no longer viable or alive. HALO ablation utilizes radio waves to generate heat energy that is delivered through the catheter to destroy the abnormal cells, leaving behind healthy tissue.
- More than one upper endoscopy and ablation may be required to eliminate the diseased tissue in the esophagus.
Post-Procedure Care and Recovery
Following the procedure, you will be transferred to the recovery room where you will be asleep or drowsy until the sedation or anesthesia wears off. Since it is an outpatient procedure, you will be discharged home on the same day of the procedure after a few hours of observation in the recovery room. You may feel pain, soreness, or discomfort in the throat once you gain consciousness. Pain and anti-nausea medications are provided as needed to address these. You should be able to take liquids once your anesthesia wears off and you no longer feel numbness in your throat. A soft or pureed diet is recommended for the first few days. You should be able to resume your normal diet in a couple of days unless your physician instructs otherwise. You can usually return to your normal activities, such as work, the next day. A follow-up appointment will be scheduled to monitor your progress.
Risks and Complications
HALO ablation for Barrett’s esophagus is a very safe procedure; however, some risks and complications may occur, such as:
- Mucosal laceration
- Esophageal narrowing
- Throat soreness
- Difficulty swallowing
- Chest discomfort
- Adverse reactions to anesthesia