April 26, 2017

FAQS- TIF

What kind of results can I expect with the TIF?
While every patient’s results will depend on their specific history and anatomy, a multi-study analysis reported in the Surgical Endoscopy Journal noted that after the second generation TIF procedure:

  • Patients completely off PPIs ranged from 82% at 12 months to 36% at 6 years
  • Patient satisfaction ranged from 58-82% at 12 months
  • Patient response to TIF (improved HRQL scores) ranged from 51-73% at 12 months to 36% at 6 years

Will I be able to belch or vomit with TIF?
Yes. A TIF procedure is a partial fundoplication and studies show patients are able to belch and vomit as needed.

When can I start eating normally again?
Patients are given a special post-operative diet to follow which takes them from clear liquids to liquids to soft foods to regular foods. Generally, you will be on soft foods for 4 to 6 weeks, depending on how you are healing.

How soon after the procedure can I resume normal physical activities?
Patients are generally able to return to non-strenuous activity within a couple of days and more strenuous activities within a few weeks. Specific restrictions will be dependent on your surgeon’s instructions.

How long is the procedure?
The TIF procedure typically takes an hour. If you are having a hiatal hernia surgically repaired during the procedure, it will take longer depending on the size and complexity of your hernia. Patients generally go home 1-2 days after surgery.

What are the risks associated with the TIF surgery?  
While all surgical procedures have risks, such as the risk of infection, bleeding and reactions to anesthesia, the most common side effects of the TIF procedure are discomfort in their nose, throat, chest and stomach for a few days to a week after the procedure. Your surgical team will discuss the risks with you prior to  your surgery.

How long will my TIF last?
The TIF procedure is intended to be a permanent solution. However, very little research reports past 3 years.

Are the TIF fasteners removed or are they permanently in my body? Will I feel them?
The fasteners remain in the body permanently. Patients should not feel the fasteners but may experience discomfort in their nose, throat, chest and stomach for a few days after the procedure. These are normal and expected side effects.

Is there any chance my reflux will return if I gain a lot of weight after the procedure?
Weight gain increases the pressure inside the abdomen, so it is possible that significant weight gain can create more pressure than the LES can counteract, leading to the return of reflux symptoms.

Will my insurance company pay for TIF procedure?
While coverage and patient costs are dependent on your specific insurance carrier and policy, nearly all insurance companies pay for antireflux surgery. Your clinical team will work with your insurance company to obtain pre-authorization for the procedure.

I had weight loss surgery and still have reflux. Am I a candidate for a TIF?
Patients who have had sleeve gastrectomies and are still experiencing reflux should consult with their surgeon for options. Generally, a TIF would not be possible due to the lack of fundus after a sleeve.

I had a TIF and now want weight loss surgery. Am I a candidate for weight loss surgery?
As long as further testing doesn’t exclude you, you may be a candidate for a weight loss operation.

If my TIF procedure isn’t effective, what are my options?
As long as further testing doesn’t exclude you and proves that reflux is present, another TIF procedure or a Nissen fundoplication may be performed.

I know I have GERD and feel better on medications. Why do I need additional testing before the procedure?
Esophageal motility testing (manometry) is needed to ensure the muscles in the esophagus generate enough pressure to push the food past the TIF augmented LES. Twenty-four hour pH testing is used to measure when, and for how long, acid is refluxed into the esophagus to prove that your symptoms correlate with actual reflux events.  An upper GI procedure or barium swallow is used to define your anatomy and help diagnose a hiatal hernia. Additionally, your insurance company may require some or all of the testing in order to pay for the procedure.