Transoral incisionless fundoplication (TIF) is an endoscope treatment designed to relieve symptoms of

gastroesophageal reflux disease Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...

(GERD). The TIF procedure, similar to

Nissen fundoplication A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical thera ...

, alleviates GERD symptoms by wrapping a portion of the stomach around the esophagus. The TIF procedure, unlike laparoscopic fundoplication, does not require surgical incisions. Instead a surgical device (called the EsophyX) is inserted into the mouth, passed through the throat, and into the stomach. An

endoscope An endoscope is an inspection instrument composed of image sensor, optical lens, light source and mechanical device, which is used to look deep into the body by way of openings such as the mouth or anus. A typical endoscope applies several modern t ...

is utilized to perform the procedure. A minority of individuals who undergo the TIF procedure also require a

hiatal hernia A hiatal hernia or hiatus hernia is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. This may result in gastroesophageal reflux disease (GERD) or laryngop ...

repair operation. The procedure is performed while the person is under general anesthesia and is typically an outpatient procedure.

Medical use

Transoral incisionless fundoplication may improve symptoms in

, at least in the short term. Benefits from the TIF procedure may last for up to 6 years.

Complications

The risk of severe complications is 2.4%. About 1 in 30 people have major complications from the procedure.

History

The device utilized to perform the procedure, called EsophyX, was developed by EndoGastric Solutions. The first TIF procedure utilizing the device was performed in 2005. The device received European Union CE mark in 2006 and United States Food and Drug Administration issued initial 510(k) clearance in 2007. In February 2015, the

American Medical Association The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's state ...

's CPT Editorial Panel reviewed whether to create a new category 1 current procedural terminology (CPT) code for the TIF procedure. In January 2016, a unique code for the transoral incisionless fundoplication procedure was created and implemented. As of 2016, more than 17,000 TIF procedures had been performed. In July 2016,

Health Care Service Corporation Health Care Service Corporation (HCSC) is a member-owned health insurance company in the United States. HCSC was formerly known as Hospital Service Corporation and changed its name to Health Care Service Corporation in 1975. The company was found ...

(HCSC) became the first United States health insurance company to add the TIF procedure to their medical coverage policy. HSCS added the TIF procedure to their health insurance policy at the recommendation of both the

American Gastroenterological Association The American Gastroenterological Association (AGA) is a medical association of gastroenterologists. Approximately 16,000 scientists and physicians are members of the organization. Overview The American Gastroenterological Association is a pr ...

(AGA) and

The Society of American Gastrointestinal and Endoscopic Surgeons ''The'' () is a grammatical article in English, denoting persons or things already mentioned, under discussion, implied or otherwise presumed familiar to listeners, readers, or speakers. It is the definite article in English. ''The'' is the m ...

(SAGES).

Other options

The TIF procedure is not the ideal GERD solution for all people. Other medical and endoscopic treatments to alleviate GERD symptoms include:

Stretta procedure Stretta is a minimally invasive endoscopic procedure for the treatment of gastroesophageal reflux disease (GERD) that delivers radiofrequency energy in the form of electromagnetic waves through electrodes at the end of a catheter to the lower eso ...

and proton-pump inhibitors (PPIs).

References

{{Reflist Digestive system procedures Endoscopy