Gastroesophageal reflux disease (GERD), also known as acid reflux, is a condition characterized by failure of the esophageal valve to prevent stomach acid from flowing back into the esophagus. Reflux surgery has long been considered the gold standard treatment for GERD in order to provide long-term symptomatic relief and prevent more severe esophageal disease.

Transoral incisionless fundoplication (TIF) is a cutting-edge reflux surgery technique in which the defective gastroesophageal valve is recreated without any external incisions. Instead, the TIF procedure utilizes visual guidance from an endoscopic instrument placed through the mouth and down the esophagus to re-establish a natural barrier to acid reflux.

Led by renowned thoracic surgeons Ali Mahtabifard, MD and Clark Fuller, MD, West Coast Thoracic Surgery offers comprehensive and state of the art care for conditions within the chest cavity. Our surgeons specialize in minimally invasive techniques for the treatment of esophageal disease, including the use of transoral incisionless fundoplication (TIF) to alleviate acid reflux symptoms and resolve the root cause of GERD.

How Does TIF Work?

The TIF procedure is performed entirely through the transoral route (mouth) using advanced endoscopic equipment. Under general anesthesia, our surgeons will gently advance a flexible camera and the EsophyX® device (EndoGastric Solutions) down the esophagus and into the stomach. The stomach is then inflated and the endoscope is turned so that our surgeons can visualize the entrance of the esophagus to the stomach (Lower esophageal sphincter).

If a small hiatal hernia (< 2cm) is present, in which part of the stomach has migrated up into the chest cavity, our surgeons will reposition the herniated tissue back below the diaphragm. The fundus tissue is wrapped around the EsophyX device and secured with durable fasteners to create a new gastroesophageal valve. The entire procedure can be completed in 45-60 minutes and is performed on an outpatient basis or a short overnight stay.

Clinical studies show that in the weeks following TIF, a natural healing process occurs to create a layer of fibrous and fibroelastic tissue which secures the new esophageal valve. Durability and efficacy of the acid reflux barrier have been confirmed in long-term studies, with results comparable to traditional reflux surgery (Nissen Fundoplication).

esophagus-disease-los-angeles-mahtabifardBenefits of the TIF Procedure

Transoral incisionless fundoplication offers numerous benefits to patients over traditional reflux surgery (Nissen Fundoplication). By using an incisionless technique, TIF does not leave any scars and carries a much lower risk of complications associated with abdominal surgery, such as infection, bloating, and dysphagia (difficulty swallowing). Additionally, recovery time following the TIF procedure is greatly reduced. Most patients experience little to no post-operative pain and can return to work within a few days symptom-free.

Eligibility for the TIF Procedure

During a thorough consultation, our thoracic surgeons will determine the most effective course of treatment based on your acid reflux symptoms and diagnostic test results. Transoral incisionless fundoplication is a highly effective procedure with a low chance of recurrence when performed on the proper candidate. To ensure the best results, the TIF procedure may be appropriate for patients who meet the following criteria:

  • Symptomatic gastroesophageal reflux disease
  • Respond to acid suppression medications
  • If hiatal hernia is present, less than or equal to 2 cm in size
  • At least 18 years old

The TIF procedure is less effective and in most cases will not be recommended for patients with severe anatomical abnormalities within the esophagus. Examples include a hiatal hernia greater than 2 cm in size, a stricture (narrowing of the esophagus), severe esophagitis, an obstruction, esophageal infection, or any other abnormality that would prohibit insertion of the EsophyX device. If our surgeons determine that you are not a candidate for the TIF procedure, you still may be eligible for reflux surgery using the highly effective Nissen Fundoplication procedure.

Contact a Los Angeles Thoracic Surgeon

West Coast Thoracic Surgery is a Los Angeles-based practice dedicated to the comprehensive treatment of diseases and conditions within the chest cavity. Having trained at some of the country’s most prestigious medical institutions, our renowned thoracic surgeons, Ali Mahtabifard, MD and Clark Fuller, MD,  possess extensive knowledge of esophageal disease and unparalleled expertise in the field of minimally invasive thoracic surgery.

To find out if you are a candidate for the TIF procedure or to schedule a consultation with one of our expert thoracic surgeons, please call 310.854.0909 or fill out our online contact form. We look forward to performing your TIF procedure in Beverly Hills today.

Next, read about Nissen Fundoplication.