TIF or Transoral Incisionless Fundoplication is a minimally invasive endoscopic procedure that is performed using an endoscope through the mouth. It creates without incisions a new valve providing outcomes similar to conventional antireflux procedures. Using the Esophyx 2.0 device and an endoscope, the stomach is wrapped around the esophagus without disrupting the stomach’s blood supply or nerves. There is less dysphagia (difficulty with swallowing food) and odynophagia (pain with swallowing) than with some of the other treatments for gastroesophageal reflux disease (GERD). Bloating and gaseousness also occur less often after this procedure than after the classic Nissen fundoplication, which is the classic surgically completed operation. Besides being able to complete this procedure without incisions, it has the advantage of being able to be performed on patients who have abnormalities in the way that their esophagus functions that may cause difficulties with some of the other available procedures. In patients with small hiatal hernias, it reduces the hernia without the need for invasive surgery. Another advantage is that it does not preclude other procedures on the stomach should they be needed in the future. In the event that symptoms recur, the procedure can be repeated. In ten year follow up studies, over 85% of patients were able to remain off of medications.
For those patients with larger hiatal hernias, I can repair the hernias with a minimally invasive technique and then complete the TIF procedure at the same time.
Most patients go home the day of surgery and resume normal activities within a few days.
I have been offering this procedure to patient’s since 2011. However, the ability to offer this procedure to patients with hiatal hernias larger than 2 cm is a new advance for this procedure.