After nearly 60 years battling severe acid reflux and a rare swallowing disorder, Palm Beach County resident Phillip Epps is finally feeling relief, thanks to a breakthrough surgery at Tampa General Hospital. The per-oral plication of the esophagus, or POPE procedure, is a minimally invasive surgery that reshapes a stretched and sagging esophagus.
“The POPE procedure makes it easier for food to go down into the stomach, helps reduce trouble swallowing and helps stop food from coming back up,” said Dr. Christopher DuCoin, chief of the TGH Digestive Diseases Institute, who performed Epps’ surgery with Dr. Salvatore Docimo, vice chair of surgery. Tampa General is one of only three hospitals in the nation to perform this procedure, and the only one in the Southeast.
Epps began coping with achalasia, a rare disorder in which the esophagus loses its ability to push food into the stomach, in his early 20s in the United Kingdom. After moving to the United States, his condition worsened despite multiple surgeries, including a Heller myotomy and a Nissen fundoplication. Long-term relief never came.
“My GI doctor at the time said there was nothing else he could do,” Epps said. The worst of his symptoms included coughing fits and severe chest pains that often sent him to the ER. “It was all very frustrating.”
After relocating to South Florida, Epps began seeing Dr. Jeffrey Garelick, a gastroenterologist with the TGH Digestive Health Center. “In the past, my doctors had always hinted that Tampa General would most likely be the only place with doctors equipped with the knowledge and expertise to treat my complex case,” Epps said.
Dr. Garelick first prescribed Epps a new drug, Voquezna, to help with his gastroesophageal reflux disease (GERD) and chest pains, and then referred him to Dr. DuCoin, who met with him remotely via telemedicine. “I felt like he really cared about me and would do everything possible to help me,” Epps recalled.
Dr. DuCoin ordered a specialized test that measures how well the esophagus functions, which confirmed Epps had end-stage achalasia. “My esophagus was like a damaged balloon, filled with puddles that caught bits of food,” Epps said.
Dr. DuCoin recommended the minimally invasive POPE procedure as an alternative to redoing Epps’ previous surgeries or removing his esophagus. “Using an endoscopic suturing device, we place triangular stitches along the walls of the esophagus, then tighten them to collapse, narrow and straighten the esophagus to help food pass smoothly and prevent pooling,” Dr. DuCoin said.
Though POPE is typically an outpatient procedure done under general anesthesia, doctors kept Epps overnight for a swallow study to confirm that there were no structural leaks before he returned to a regular diet.
Nearly six weeks after the procedure, Epps is back to eating normally. A self-professed foodie and amateur chef, he’s looking forward to cooking for family and friends again, and trying a nearby MICHELIN-starred Cuban restaurant.
“I am so grateful to Dr. DuCoin, Dr. Docimo and Dr. Garelick for their care and compassion,” he said. “Now I can get back to enjoying my life.”
For more information about the advanced, complex care offered at Tampa General Hospital, please visit TGH.org/ThePalmBeaches.
