First of all, TIF is a minimally invasive, anti-reflux therapy for acid reflux disease (GERD). This is also known as heartburn. Furthermore, fundoplication literally means “wrap.” Consequently, during a TIF procedure, part of the stomach is wrapped around the esophagus (food pipe). Lastly, this is to prevent reflux of stomach acid contents upward. Next, GERD is a disease where acid from the stomach ‘refluxes’ back into the esophagus. In addition, this is what causes various symptoms such as heartburn, bloating as well as sometimes chronic cough. Furthermore, GERD has become exceedingly common as 1 in 4 Americans suffer from the disease. Risk factors include obesity, poor diet, smoking, alcohol intake, diabetes, and hiatal hernia. Methods of treatment include dietary, lifestyle changes along with medical, endoscopic and surgical options. The mainstay of medical therapy is antacid therapies – which help reduce or neutralize acid in the stomach.
Patients who do not respond to conservative therapy with diet and medication may need to undergo an anti-reflux procedure to get their symptoms under control. In the past, patients would have to go through an invasive surgery known as a Nissen Fundoplication to treat their GERD. We can now achieve the same ‘wrap’ and anti-reflux benefits with an endosocopic procedure – which is minimally invasive, does not require skin incisions, and is very effective.
During the TIF procedure, an endoscope fitted with a special device is inserted through the mouth while under general anesthesia. The endoscope and the device allow for creation of a wrap of the stomach around the bottom of the esophagus with specially designed H-shaped fasteners. Clinical trials have shown that TIF is more effective at controlling GERD symptoms compared to medications. There is no preparation the patients must drink for the TIF procedure. Patients need to be NPO (not eating/drinking) after midnight prior to the procedure. During the procedure, patients will be under general anesthesia and then admitted to the hospital for an overnight observation. It usually takes about 1 hour and patients are routinely discharged the following day.