It provides uniform and controlled therapy at a consistent depth, which can remove Barrett’s lining cells from the oesophagus and allow the regrowth of normal cells. The HALO 360 Ablation System uses a balloon based electrode to eradicate Barrett’s lining cells circumferentially within the oesophagus. This is used as the initial treatment for circumferential Barrett’s mucosa. The HALO 90 Ablation System is an electrode system that is mounted on the end of an endoscope, allowing the physician to treat smaller areas of diseased tissue. This is generally used at followup endoscopies, for any remaining smaller areas of Barrett’s mucosa.
Careful assessment of patients with dysplastic Barrett’s is essential to ensure that HALO RFA is the appropriate and optimal treatment. Decision making is complex in individuals with high grade dysplasia. Therefore, the usual workup after referral will include: consultation, thorough endoscopic assessment and biopsy mapping.
A procedure to remove areas of visibly abnormal tissue called “endoscopic mucosal resection” (EMR, see above) may be required to both assess and treat that area prior to HALO RFA. In patients in whom early cancer is detected, further tests will be required to fully assess the stage of the disease, which will in turn determine the treatment options available, including the possibility of surgery.
HALO radiofrequency ablation is available at very few centres in Victoria. It is performed by Dr Taylor and Dr Cameron at St Vincent’s Hospital.