The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Endoluminal gastroplication for gastro-oesophageal reflux disease.

It replaces the previous guidance on endoluminal gastroplication for gastro-oesophageal reflux disease (NICE interventional procedures guidance 115, February 2005).


In patients with gastro-oesophageal reflux disease, the acidic contents of the stomach are able to travel backwards into the gullet (oesophagus), causing a burning sensation or pain (heartburn) or awareness of an acidy sensation or taste. This happens because the ring of muscle that keeps the stomach contents down isn’t working properly.

Endoluminal gastroplication uses a long camera and special instruments inserted through the mouth into the gullet. The surgeon uses the instruments to stitch and fold the lower end of the gullet where it joins the stomach to make the junction between the stomach and the gullet smaller, and so help prevent backwards movement of the stomach contents.

Coding recommendations

G46.1 Fibreoptic endoscopic endoluminal plication of gastro-oesophageal junction.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)