Transoral Incisionless Fundoplication (TIF)
TIF aims to correct the root cause of GERD. TIF is completely incisionless as it is performed with the assistance of an endoscope and is performed from inside the stomach.
The procedure reconstructs a durable anti-reflux valve and tightens the lower esophageal sphincter. This re-establishes the reflux barrier and restores the competency of the LES.
Is TIF Truly Incisionless?
TIF is a completely incisionless procedure, but it is real surgery. It falls into a category of procedures called natural orifice surgeries, because the device is introduced into the body through the mouth rather than by making incisions on the abdomen.
The advantages of incisionless surgery are a short hospital stay, reduced discomfort, no visible scars and high patient satisfaction.
How is TIF Performed?
While a patient is asleep under general anesthesia, the device is introduced into the body through the mouth and advanced into the esophagus under visualization of an endoscope (flexible camera). The device is then used to grab portions of the stomach and the esophagus. Utilizing specialized fasteners, several tissue folds (plications) are created encircling the LES. This creates a robust anti-reflux valve. Small hiatal hernias can be corrected at the same time.
Is TIF Effective?
Over 5000 patients have undergone a TIF worldwide.
Clinical studies have measured symptoms, quality of life, use of PPI’s, impedance, pH-metry and manometry to assess the effectiveness.
- TIF improves typical symptoms such as heartburn and regurgitation in 75-89% of patients.
- TIF eliminates atypical symptoms such as cough and hoarseness in 72-90% of patients.
- TIF eliminates the need for daily medications in greater than 90% of patients.
- Allows for an effective, long-term solution to GERD
- Similar effectiveness to laparoscopic procedures (with proper patient selection)
- No external incisions – no scarring
- Rapid Recovery
- With early intervention, eliminates heartburn and need for medications in most patients
- Does not limit future treatment options
- Can be revised endoscopically or laparoscopically, if required
- Have heartburn or non-heartburn acid reflux symptoms two or more times a week
- Have symptoms on acid reflux medications
- Cannot tolerate the side effects of acid reflux medications
- Do not wish to use acid reflux medication in the long term
TIF does not create a 360-degree wrap such as the laparoscopic fundoplication and cannot fix medium to large hiatal hernias, so it is best used for moderate refluxers with small hiatal hernias. It is not as effective when used on patients with severe reflux and large hiatal hernias. These patients are well treated with laparoscopic approaches, which are time tested, well tolerated and durable.
By correctly assessing patients and making the right decision as to which procedure is best for each individual person, The Reflux Center is able to maximize the number of satisfied, medication-free and symptom-free patients treated.
After undergoing the TIF procedure, patients are kept in the hospital overnight. Most patients can return to work within a few days following their TIF procedure. Patients should expect to experience some discomfort in their chest and throat for the first few days. Patients will be asked to restrict physical activity for the first month and will be given dietary guidelines to help maximize their success while their tissue heals.
Benefits of TIF
TIF is Suitable for Those Who:
Patients report a high degree of satisfaction with the TIF procedure. The high success rate combined with shorter recovery time and reduced discomfort make this incisionless acid reflux treatment a valuable new option for acid reflux sufferers in the Tampa Bay Area.
Gopal Grandhige, MD