April 9, 2017

Transoral Incisionless Fundoplication (TIF)

TIF is a minimally invasive outpatient procedure for the treatment of gastroesophageal reflux disease (GERD). The procedure uses a special instrument, which is fed through the mouth and esophagus to the stomach, to create a 270 degree wrap of the upper part of the stomach (fundus) around the lower esophageal sphincter (LES). The wrap is secured to the LES using H-shaped fasteners from the inside of the stomach versus suturing the fundus around the outside of the LES as in a traditional fundoplication.

The Transoral Incisionless Fundoplication.

The TIF procedure was approved by the FDA in 2007 and has had several device and technique modifications since. The procedure is well studied and demonstrates short term improvement in reflux symptoms and PPI dependence; however, the procedure’s effectiveness decreases over time.(1) The most common side or postoperative effects are sore throat or a lump in the throat feeling, difficult or painful swallowing, nausea, left shoulder pain and abdominal pain.

Candidates for TIF include individuals who continue to experience symptoms of chronic GERD, are dissatisfied with antireflux medication results and do not want reflux surgery to manage their GERD. TIF is not indicated for patients with a hiatal hernia greater than 2 cm.

A comparison of the TIF procedure with other procedures can be found on our pros and cons page.

1. Huang X, Chen S, Zhao H, Zeng X, Lian J, Tseng Y, Chen J. Efficacy of transoral incisionless fundoplication (TIF) for the treatment of GERD: a systematic review with meta-analysis. Surg Endosc. 2016 Aug 5 (Epub)