Gastroesophageal reflux disease (GERD), also known as acid reflux, is a common condition in which contents of the stomach back up into the esophagus, causing a variety of symptoms, the most frequent of which is heartburn.
Treatment typically involves making certain lifestyle changes or taking medications to neutralize or decrease stomach acid output. But when these steps are not enough to control the condition, another option is surgery.
One surgical technique is called "transoral incisionless fundoplication," or TIF. The procedure is a natural orifice surgery because the equipment used to perform the operation is introduced into the body through the mouth instead of through an abdominal incision.
During TIF, an endoscope (a long, thin, flexible tube that has a light and video camera on the tip) and another specially designed device are passed into the stomach through the mouth. The surgeon then inserts multiple small, plastic fasteners through the central shaft of the device.
The fasteners are used to make several tissue folds to recreate the lower esophageal sphincter, thus preventing stomach acid from backing up into the esophagus.
Depending on the patient's age, gender and overall health, preparing for TIF surgery might or might not involve some routine blood tests, an EKG and chest X-ray.
No food or drink is allowed eight hours before surgery. Some medications might need to be stopped prior to surgery, including blood thinners such as aspirin, Coumadin and Plavix.
TIF is typically performed under general anesthesia. The entire procedure lasts approximately one to two hours and the patient usually remains in the hospital for less than two days.
TIF has several advantages over conventional laparoscopic or traditional surgery for GERD, including reduced patient discomfort, more rapid recovery and lower risk for infection. The procedure can also be reversed, can be performed again and leaves options open for future treatment.
After surgery, patients are required to follow a liquid diet for two weeks followed by a soft diet for four weeks.
Not all patients with GERD are candidates for TIF surgery. As with any procedure, there are side effects associated with TIF, including shoulder and abdominal pain, nausea and sore throat.
However, in a study published in the World Journal of Surgery, side effects for patients who underwent the operation were reported as few, mild and transient.
For more information about TIF, talk with your doctor.
Dr. Carlos Montenegro is a board-certified surgeon associated with Hilton Head Regional Healthcare.