TIF: Incisionless Surgery for Chronic Heartburn or Reflux
TIF (transoral incisionless fundoplication) is the latest treatment for
safely and effectively treating chronic acid reflux disease, also known
as gastroesophageal reflux disease (GERD). A completely incisionless
procedure, TIF reconstructs the antireflux barrier to provide a solution
to the anatomical root cause of GERD. The procedure is for patients who
are dissatisfied with current pharmaceutical therapies or are concerned
about the long-term effects of daily use of reflux medications.
TIF is performed endoscopically using the innovative EsophyX surgical
device from EndoGastric Solutions. In clinical studies, 79 percent of
patients remained off daily PPIs (proton pump inhibitors) and 93 percent
experienced a total elimination of heartburn at two years after the TIF
This procedure is performed by Dr.
Bob Etemad and Dr. Alicia McKelvey at Lankenau Medical Center.
What is GERD?
If you have heartburn or reflux twice a week or more, you may have GERD.
Heartburn is the most common symptom, but you may also experience:
Hoarseness or sore throat
Asthma or asthma-like symptoms
Pain or discomfort in the chest
Sleep disruption (unable to sleep lying down)
Excessive clearing of the throat
Burning in the mouth or throat
Intolerance of certain foods
Dental erosions or therapy-resistant gum disease or inflammation
Normally, after swallowing, a valve between the esophagus and stomach
opens to allow food to pass, then it closes to prevent stomach contents
from “refluxing” back into the esophagus, causing a burning sensation in
the chest. For people who suffer from GERD, the valve is dysfunctional
and unable to prevent acid from refluxing into the esophagus.
Why pharmaceuticals are not a long-term solution
GERD today is typically treated with medications such as histamine
receptor antagonists (H2 blockers), such as Pepcid, Tagamet and Zantac,
and proton pump inhibitors (PPIs), such as Nexium, Prilosec and
Protonix. These medications can lose their effectiveness over time. They
also don’t treat the underlying root causes of reflux, the deteriorated
anatomy of the antireflux barrier, so life-long medication therapy is
required. In addition, recent studies on the adverse effects of
long-term use of PPIs indicate a significantly higher incidence of hip
fractures, particularly among women.
Conventional surgical treatment
For people who have severe GERD, surgical intervention may be required.
Though the conventional laparoscopic procedure has long been proven a
very effective long-term solution, it is still “invasive.” It includes
incisions and patients must remain in the hospital for up to several
days. For that reason, the number of GERD sufferers who undergo the
procedure is relatively small.
TIF was developed to emulate more invasive surgical techniques, but from
within and completely without incisions and visible scars. Using the
FDA-cleared EsophyX device, the procedure is performed through the
mouth, rather than through an abdominal incision. Typically lasting no
more than 50-60 minutes, the procedure is performed under general
anesthesia and reconstructs the antireflux barrier to restore the
competency of the gastroesophageal junction. Most patients can go home
the next day and return to work within a few days.
Call 1.866.CALL.MLH for questions and to make an appointment with a Main
Line Health doctor today.
For more information, call 1.866.CALL.MLH.