TRANSORAL INCISIONLESS FUNDOPLICATION (TIF)

The Transoral Incisionless Fundoplication using the Esophyx device was approved by the FDA for use in 2007 for the treatment of chronic reflux/GERD.  Dr. Chiasson initially began offering this procedure at that time to a small number of patients.  More recently, after additional long-term published data re-enforced the earlier results, he has begun offering the procedure again for those individuals seeking an Incisionless non-surgical solution to their issues with GERD/LPRD.

What is the Transoral Incisionless Fundoplication?

The Transoral Incisionless Fundoplication / TIF® procedure is an endoscopic anti-reflux procedure.  The procedure utilizes the EsophyX 2.0 device to reconstruct the gastroesophageal valve and help restore its function as a reflux barrier.

The TIF reconstruction of the GEV can be used in patients with no hiatal hernia as a stand-alone procedure.  Alternatively, it can be used in conjunction with a laparoscopic hiatal hernia repair to restore both the anatomy of the hiatus and the anatomy of the GEV.

 

Who is a candidate for a Transoral Incisionless Fundoplication?

The Transoral Incisionless Fundoplication is ideally suited in patients with GERD/LPRD with no significant hiatal hernia (< 2 cms).  This generally represents a small population of patients with severe GERD/LPRD.  More recently, it is being used in combination with laparoscopic hiatal hernia repair to address GERD/LPRD issues.  This is called a cTIF procedure.  At this time, there is an ongoing investigation to determine how well this procedure performs relative to the current techniques.

 

How does the Transoral Incisionless Fundoplication work?

The Transoral Incisionless Fundoplication is performed by placing a flexible video endoscope within the central lumen of the EsophyX 2.0 device.  This provides direct visualization throughout the TIF procedure.  The device is placed into the stomach and turned to look up at the Gastro-Esophageal Valve (GEV).  The device is then used as a fastener delivery system.  The valve is pulled into the Esophyx device and utilizes tissue-manipulating elements to deploy approximately 20 SerosaFuse fasteners.   The result is the creation of a 2-3 cm, 270° esophagogastric fundoplication.

 

What should you expect after a Transoral Incisionless Fundoplication?

The Transoral Incisionless Fundoplication is an outpatient procedure.  It is performed under general anesthesia.  I use the latest pain and nausea control techniques and most patients experience minimal symptoms afterward.  Patients who have this procedure are instructed to follow a very strict diet progression over the next 6-8 weeks intended to promote healing and achieve the best outcomes.

 

Advantages of the Transoral Incisionless Fundoplication (TIF) Procedure?

The Transoral Incisionless Fundoplication provides an Incisionless non-surgical solution to the problem of severe GERD/LPRD.  It helps to restore the normal function of the sphincter that separates the esophagus and the stomach.  It acts to eliminate or significantly reduce the reflux of gastric juices into the esophagus.

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