Transoral incisionless fundoplication

Pronunciation
Other names
Medical specialty	gastroenterology
Uses
Complications
Approach
Types
Recovery time
Other options
Frequency

Transoral incisionless fundoplication (TIF) is an endoscope treatment designed to relieve symptoms of gastroesophageal reflux disease (GERD). The TIF procedure, similar to Nissen fundoplication, alleviates GERD symptoms by wrapping a portion of the stomach around the esophagus.<ref name=":1">

Is It GERD? Recognizing Atypical Symptoms | Physician's Weekly for Medical News, Journals & Articles(link). www.physiciansweekly.com.

Accessed 2017-05-18.

</ref>

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 is utilized to perform the procedure.<ref name=":2">

GERD Device Maker Uses Clinical Data to Prove Its Point | MDDI Medical Device and Diagnostic Industry News Products and Suppliers(link). www.mddionline.com.

2015-03-12.

Accessed 2017-05-18.

</ref>

A minority of individuals who undergo the TIF procedure also require a hiatal hernia repair operation.<ref> Kennedy, Sam,

 New Easton Hospital procedure fixes heartburn Full text, 
 themorningcall.com, 
  
  
  
  
 Accessed on: 2017-06-06.

</ref> The procedure is performed while the person is under general anesthesia<ref>

MCW: Endoscopic Transoral Incisionless Fundoplication(link). www.mcw.edu.

Accessed 2017-05-18.

</ref> and is typically an outpatient procedure.<ref name=":1" />

Medical use

Transoral incisionless fundoplication may improve symptoms in gastroesophageal reflux disease, at least in the short term.<ref name=We2013/> Benefits from the TIF procedure may last for up to 6 years.<ref>Hopkins, Jessica,

 Update on novel endoscopic therapies to treat gastroesophageal reflux disease: A review, 
 World Journal of Gastrointestinal Endoscopy, 
 
 Vol. 7(Issue: 11),
 pp. 1039–1044,
 DOI: 10.4253/wjge.v7.i11.1039,
 PMID: 26322157,
 PMC: 4549661,</ref>

About 1 in 30 people have major complications from the procedure.<ref name="We2013">,

 Impact of transoral incisionless fundoplication (TIF) on subjective and objective GERD indices: a systematic review of the published literature., 
 Surgical Endoscopy, 
 
 Vol. 27(Issue: 10),
 pp. 3754–61,
 DOI: 10.1007/s00464-013-2961-0,
 PMID: 23644835,</ref>

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.<ref name=":0">Sami Trad, Karim,

 Transoral incisionless fundoplication: current status, 
 Current Opinion in Gastroenterology, 
 
 Vol. 32(Issue: 4),
 pp. 338–343,
 DOI: 10.1097/MOG.0000000000000275,
 PMID: 27023164,
 PMC: 4894777,</ref>  The device received European Union CE mark in 2006 and United States Food and Drug Administration issued initial 510(k) clearance in 2007.<ref name=":2" /><ref>

,

 Incision-free surgery treats acid reflux: Allegan surgeon is training other doctors to do the procedure Full text, 
 MLive.com, 
  
  
  
  
 Accessed on: 2017-05-10.

</ref>

In February 2015, the American Medical Association'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.<ref>

AMA creates CPT code for transoral incisionless fundoplication procedure for GERD(link). www.healio.com.

Accessed 2017-06-06.

</ref>

As of 2016, more than 17,000 TIF procedures had been performed.<ref name=":0" />

In July 2016, Health Care Service Corporation (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 (AGA) and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).<ref> ,

 TIF procedure for reflux now covered by Blue Cross Blue Shield of Texas Full text, 
 Plainview Daily Herald, 
  
  
  
  
 Accessed on: 2017-05-10.

</ref>

Other options

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

• Stretta procedure<ref>Hopkins, Jessica,

 Update on novel endoscopic therapies to treat gastroesophageal reflux disease: A review, 
 World Journal of Gastrointestinal Endoscopy, 
 
 Vol. 7(Issue: 11),
 pp. 1039–1044,
 DOI: 10.4253/wjge.v7.i11.1039,
 PMID: 26322157,
 PMC: 4549661,</ref>

• Proton-pump Inhibitors (PPIs)<ref>Trad, Karim S.,

 Transoral Incisionless Fundoplication Effective in Eliminating GERD Symptoms in Partial Responders to Proton Pump Inhibitor Therapy at 6 Months, 
 Surgical Innovation, 
 
 Vol. 22(Issue: 1),
 pp. 26–40,
 DOI: 10.1177/1553350614526788,
 PMID: 24756976,
 PMC: 4361451,</ref>

References

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