Transoral Incisionless Fundoplication Failure and Revisional Intervention

Oscar M. Crespin, MD; Brant Oelschlager, MD


August 07, 2014

Transoral Incisionless Fundoplication for GERD

Gastroesophageal reflux disease (GERD) is the most common disease encountered by gastroenterologists, affecting 10%-20% of the Western population.[1] Laparoscopic antireflux surgery is indicated for patients whose disease is poorly controlled with proton pump inhibitors (PPIs).

Although minimally invasive procedures have made surgery more acceptable to patients and providers, many would prefer a less invasive approach to assist with breakthrough symptoms. As a result, there has been significant interest during the past decade to further reduce the morbidity of minimally invasive procedures and eliminate the need for abdominal scars altogether by developing endoluminal therapies for GERD.

Transoral incisionless fundoplication (TIF) is an endoscopic procedure that creates an esophagogastric fundoplication using a device, EsophyX® (EndoGastric Solutions; Redmond, Washington), and visual guidance from an endoscope. TIF adheres to the same fundamental surgical principle of creating a full-thickness esophagogastric fundoplication to correct an incompetent lower esophageal sphincter with a transoral approach.


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