Transoral Incisionless Fundoplication

Transoral incisionless fundoplication (TIF) is a minimally invasive procedure used to treat patients with chronic acid reflux, or GERD.

What is TIF?

Transoral incisionless fundoplication (TIF) is an advanced endoscopy procedure that provides relief from symptoms of acid reflux, such as heartburn or regurgitation, associated with gastroesophageal reflux disease (GERD). The procedure does not involve incisions or metal implants.

Why is TIF performed?

Patients who are experiencing symptoms of acid reflux, such as heartburn or regurgitation, associated with gastroesophageal reflux disease (GERD) have a malfunctioning valve that allows stomach acid to backflow into the esophagus. In some cases, proton-pump inhibitors (PPIs) or other antacid medications are no longer effective in treating a patient’s GERD symptoms or do not provide the patient with complete relief and valve repair may be their only option. In other cases, patients may have GERD symptoms that respond to PPIs or other antacid medications; however, they wish to avoid these options and seek relief through valve repair.

How do I know if I am a candidate for TIF?

Your physician will conduct a thorough assessment of your symptoms and current medications to determine if you are a candidate for the TIF procedure. If you are a candidate, you will be provided with information on how to prepare for the procedure, which includes a special pre-operative diet plan.

You may be a candidate for TIF if one of the following applies to you:

• You have been using proton-pump inhibitors (PPIs) for many years, but your reflux symptoms are no longer being controlled (30-40% of all patients on PPIs are in this category)
• You are suffering from atypical symptoms of reflux, such as asthma, persistent cough, or sore throat
• You have a significant hiatal hernia
• You don't want to take medication any longer
• You are not eligible for conventional anti-reflux surgery

What can I expect during TIF?

During the TIF procedure, you will be placed under general anesthesia. An endoscope, a thin, flexible tube with a camera attached, is fed through a special TIF device that is preloaded with forceps (special tweezers) and plastic fasteners. Together, the endoscope and TIF device are passed through your mouth, down your esophagus, and into your stomach, allowing your physician to repair or reconstruct your body’s natural barrier to reflux (the anti-reflux valve) at the gastroesophageal junction. The TIF device allows your physician to grab the end of your esophagus and pull it down so that the top of the stomach can be wrapped 270 degrees around the esophagus and secured with a plastic fastener that remains in the body. This procedure replicates the function of the gastroesophageal valve by allowing the newly created anti-reflux valve to naturally stretch and contract at the gastroesophageal junction, which protects the esophagus against refluxing stomach acids. The entire procedure typically takes less than one hour to perform.

What can I expect after undergoing TIF?

Following your procedure, your physician may choose to keep you in the hospital overnight. However, some patients may return home the same day. Many patients will be able to resume work and other daily activities within a few days. You may experience some discomfort in your stomach, chest, nose, and throat for 3-7 days following the procedure. Your doctor will also place you on a specialized diet for the first 6 weeks following the procedure so that your newly reconstructed valve can heal properly. Patients should experience instant relief from their GERD symptoms and when following up with patients 5 years after undergoing the TIF procedure, studies show that the majority (80%) of these patients are no longer using proton-pump inhibitors (PPIs) and remain symptom-free.

Care Team Approach

Digestive Health, a clinical partnership between Ascension Seton and UT Health Austin, takes a multidisciplinary approach to your care. This means you will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include gastroenterologists, surgical and non-surgical heartburn and esophageal disorders specialists, physician assistants, nurses, advanced practice providers, dietitians, social workers, and more, providing unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating your care with your other healthcare providers to ensure that we are providing you with comprehensive, whole-person care.

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