What is a TIF procedure? Transoral incisionless fundoplication is a minimally invasive procedure to treat acid reflux, also known as heartburn, and other symptoms associated with chronic gastroesophageal reflux disease (GERD).
Laparoscopic Fundoplication
The surgeon then takes a portion of the upper stomach, called the fundus, and wraps it around the bottom of the esophagus to form a valve between the stomach and the esophagus. This strengthens the lower esophageal sphincter, which prevents stomach acid from flowing up into the esophagus.
The newest therapy is the transoral incisionless fundoplication (TIF). This is an incisionless fundoplication performed with an endoscope that is inserted through the mouth and into the stomach. Short-term results appear favorable in carefully selected patients; however, long-term studies have not yet been completed.
Fundoplication is the gold standard of GERD surgeries. During the procedure, the surgeon uses the upper part of the stomach to reinforce and tighten the lower esophagus and strengthen the sphincter, which is the bundle of muscles that helps prevent the contents of the stomach from moving back up the esophagus.
Presently, there are three endoscopic techniques that are approved for GERD, including the Stretta procedure, transoral incisionless fundoplication (TIF), and Medigus ultrasonic surgical endostapler (MUSE).
In RCTS, this device has shown to be 70% effective in controlling GERD symptoms with an overall adverse event rate of 2%11; however, the device requires advanced training, general anaesthesia and 45–100 min to complete the procedure. GERD-X (G-SURG, Germany) is a novel endoscopic plication device introduced in 2014.
The Stretta system delivers low power, low temperature radiofrequency (RF) energy to the lower esophageal sphincter (LES) muscle and gastric cardia. This energy remodels the tissue, resulting in improved barrier function and fewer random relaxations that cause reflux symptoms.
Side effects of anti-reflux surgery are related to the creation of a valve at the lower esophageal sphincter where none previously existed. These may include: Difficult, painful swallowing that may last up to three months, but is usually gone in 4 to 6 weeks. It may be associated with pain in the shoulder as well.
The Food and Drug Administration (FDA) has accepted for review the resubmitted New Drug Application (NDA) for vonoprazan for the treatment of erosive gastroesophageal reflux disease (GERD). A Prescription Drug User Fee Act target date of November 17, 2023 has been set for the application.
Ways of relieving the symptoms of gastroesophageal reflux disease (GERD) include avoiding food triggers, changes to dietary habits, sleeping with the head raised and using supplements, such as ginger. To help a person manage the often painful and uncomfortable symptoms of GERD, doctors may recommend home remedies.
Side effects of Nissen fundoplication such as dysphagia, increased bloating and flatulence, and inability to belch or vomit may limit the success of antireflux surgery[12,13].
As a result of changes caused by these operations, most patients will experience some weight loss. The capacity of the stomach is decreased slightly and it doesn't distend as much until healing occurs. On average, our patients lose approximately 10% of their weight.
Most patients see an improvement in their symptoms after the procedure and no longer require daily medication. Patients who are elderly, have other health problems, or have weak peristalsis (digestive motion) are not good candidates for a Nissen Fundoplication.
Most people go back to work 2 to 3 weeks after laparoscopic surgery and 4 to 6 weeks after open surgery. You may have a feeling of tightness when you swallow for 6 to 8 weeks. This is from the swelling inside your esophagus. You may also have some bloating.
It's safe to take paracetamol at the same time as Gaviscon but do not take ibuprofen or aspirin with it. If you've bought Gaviscon without a prescription, do not take it for longer than 7 days without checking with a doctor. There are different types of Gaviscon. Ask your doctor or pharmacist which one is best for you.
TIF surgery is FDA-approved and highly effective at curing GERD. Not only do patients get to put an end to their GERD symptoms, but they also reap the following benefits: No bloating or flatulence so there's no need to worry about embarrassing or noxious odors or sounds.
With most people, GERD can be controlled with medication, but when symptoms persist despite medication, surgery is the only option. The procedure is known as a fundoplication. That involves building a new barrier that prevents acid reflux from occurring.
There is usually minimal pain associated with this operation. The abdomen will be sore as well as the small incision sites, and some patients have shoulder pain for the first day or two.
The procedure is performed using minimally invasive techniques and is done under a general anesthesia. With anti-reflux surgery, surgeons will fix a hiatal hernia, when the upper part of the stomach pushes through the diaphragm, if it is present by suturing it closed.
Antacids are among the safest drugs for acid reflux and side effects are rare.
If there isn't any dysplasia the need for serial endoscopy should be performed no more often than once 3 to 5 times per year. If dysplasia is detected it is recommended to have more frequent intervals recommended due to the greater chance of cancer progression.