Ask the Experts Blog

Over twenty million Americans have daily heartburn or other symptoms of reflux such as regurgitation, chronic cough, hoarseness and dental erosions. Around 6.7 million suffer from uncontrolled gastroesophageal disease (GERD), while less than 30,000 elect to have surgery.  

“In the past, for patients with mild disease we would simply recommend lifestyle modifications such a losing weight or changing eating habits,” said general surgeon, Seth Miller, MD. “For those with more frequent heartburn that’s impacting their quality of life we would recommend medications. Only for those with severe symptoms would we look at surgery as it used to be much more invasive and could potentially lead to complications.”  

This is no longer the case with the addition of the Transoral Incisionless Fundoplication (TIF®) procedure which is performed without incisions and now available at Lakeland General Surgery, Niles.  

“We are trying to expand the group of patients we can help who aren’t being adequately treated through lifestyle modifications or medications alone,” said Dr. Miller. “We want to solve the problem without over fixing it. The TIF procedure is much less invasive option and allows us to lower the risk and optimize the effectiveness.” 

What happens during the procedure?  

During the procedure, a flexible endoscope and a device are inserted through the mouth and into the esophagus. Once positioned in the stomach, the device uses fasteners to rebuild the valve with surrounding esophageal and stomach tissue. Once the valve is rebuilt it will prevent stomach acid from washing back up into the esophagus. 

“Since this procedure is incisionless, patients have less risk for side effects common with previous anti-reflux operations such as dysphagia, a condition that makes it difficult to swallow foods or liquids,” said Dr. Miller. “Patients will also still be able to belch or vomit if needed because the valve isn’t overly constricted.” 

How effective is this surgery?  

Studies show for patients who underwent surgery, on average, 81% are off PPI medications all together. Those who are still taking medications are typically at much lower doses. In addition, about 84% of patients who had inflammation of the esophagus, which can lead to cancer, also saw improvement. Patients in the studies also complete a health-related quality of life questionnaire before and after surgery to rate their frequency and severity of their symptoms such as heart burn or regurgitation.  

“Two years after patients underwent the procedure, we saw their health-related quality of life scores decrease from 45 to 50 down to less than 20—which is a significant improvement,” said Dr. Miller. “As time went, 10 years after surgery, their scores decreased to less than 10 showing us that symptoms continued to improve and quality of life was higher.”  

Am I a candidate for the TIF® procedure?  

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