With health care becoming increasingly data driven, third-party payors are requiring a higher level of evidence before making a positive coverage determination for a new technology or procedure. This has made the road to reimbursement much longer and tougher for device companies in general, and manufacturers of transoral devices for GERD are a prime example.

Device incubator Synecor has solved one of the most taxing problems incubators face-an adequate financing model-with a string of deals as impressive as the technology it has launched.

Gastroesophageal reflux disease and Barrett's Esophagus seem like obvious-and enormous-potential markets for interventional devices, but so far such devices have disappointed. In GERD, product malfunctions and recalls have underscored safety issues, while efficacy concerns and reimbursement delays have conspired to keep the enormous opportunity that GERD represents tantalizingly out of reach for many of the first-generation companies that were launched to tap into this market. Now, a small group of companies with hopes of a better approach are betting they've found the way to harness this most promising of device markets.

NDO Surgical Inc.'s Endoscopic Full-Thickness Plicator, a noninvasive device designed to relieve the symptoms of gastroesophageal reflux disease in an outpatient setting, just received FDA clearance and is poised to enter the billion dollar GERD market.