Several methods and apparatus are available for treating patients that suffer
from both gastro-esophageal reflux disorder and hiatal hernias. In order to treat
these patients, an endoscopic probe may be used to push the herniated stomach below
the diaphragm. In some embodiments, a two-part stent comprising a funnel stent
and a reverse stent may be deployed to prevent a future re-herniation of the stomach
and to reduce the annulus of the lower esophageal sphincter. In some embodiments,
a reverse stent with perforating barbs may be deployed, in which the barbs penetrate
the esophageal wall and attach to the diaphragm. In some embodiments, the crus
muscles may be sutured together to reduce the hiatus size and a reverse stent may
be deployed to reduce the annulus of the lower esophageal sphincter.