Reviewed by: F. P. “Tripp” Buckley, MD, FACS
Written by: Ashley Lawrence
Patients who are experiencing symptoms of acid reflux, such as heartburn, regurgitation, and difficulty swallowing (dysphagia), associated with gastroesophageal reflux disease (GERD) have a malfunctioning valve that allows stomach acid to backflow into the esophagus. Oftentimes, these patients turn to proton pump inhibitor (PPI) drugs, such as omeprazole and esomeprazole, to help soothe their symptoms of GERD.
In some cases, PPIs or other antiacid medications are no longer effective in treating a patient’s GERD symptoms or do not provide the patient with complete relief and valve repair may be their only option. In other cases, patients may have GERD symptoms that respond to PPIs or other antiacid medications; however, they wish to avoid these options and seek relief through valve repair.
Digestive Health, a clinical partnership between UT Health Austin and Ascension Seton, is the only clinical practice in Central Texas currently offering transoral incisionless fundoplication (TIF), an advanced endoscopy procedure that provides relief from symptoms of GERD. The TIF procedure is minimally invasive and does not involve incisions or metal implants.
“TIF is an excellent fix for heartburn,” says UT Health Austin board-certified surgeon F. P. “Tripp” Buckley, MD, FACS, who serves as the Surgical Director of Digestive Health. “It beats PPIs in terms of both durability and effectiveness, and it’s comparable in quality to a world-class laparoscopic fundoplication.”
Persistent GERD can damage the valve between the stomach and esophagus and cause a tear known as a hiatal hernia. A hiatal hernia occurs when the upper part of the stomach bulges through a small opening in the diaphragm (hiatus) and enters the chest. UT Health Austin board-certified gastroenterologist David Tang, MD, performs the TIF procedure in concert with Dr. Buckley, who is able to repair the patient’s hiatal hernia at the time of the TIF procedure.
During the TIF procedure, the patient is placed under general anesthesia. A flexible, tube-like imaging instrument known as an endoscope is fed through a special TIF device that is preloaded with forceps (special tweezers) and plastic fasteners. Together, the endoscope and TIF device are passed through the mouth, down the esophagus, and into the stomach, allowing the physician to repair or reconstruct the body’s natural barrier to reflux (the anti-reflux valve) at the gastroesophageal junction. The TIF device allows the physician to grab the end of the esophagus and pull it down so that the top of the stomach can be wrapped 270 degrees around the esophagus and secured with a plastic fastener that remains in the body.
The TIF procedure replicates the function of the gastroesophageal valve by allowing the newly created anti-reflux valve to naturally stretch and contract at the gastroesophageal junction, which protects the esophagus against refluxing stomach acids. The entire procedure typically takes less than one hour to perform, and patients should experience instant relief from their GERD symptoms. When following up with patients 5 years after undergoing the TIF procedure, studies show that the majority (80%) of these patients are no longer using PPIs and remain symptom-free.
To determine whether a patient is a candidate for the TIF procedure, a thorough assessment of the patient’s symptoms and current medications must be conducted.
You may be a candidate for the TIF procedure or other anti-reflux procedures offered through Digestive Health if one or more of the following applies to you:
- You have been using proton-pump inhibitors (PPIs) for many years, but your reflux symptoms are no longer being controlled (30-40% of patients on PPIs fall in this category)
- You are suffering from atypical symptoms of reflux, such as asthma, persistent cough, or sore throat
- You have a significant hiatal hernia
- You do no want to take medication any longer
- You are not eligible for conventional anti-reflux surgery
To make an appointment with the Heartburn and Esophageal Disorders clinical practice or to learn more about services offered through Digestive Health, call 1-844-GI-AUSTIN (1-844-442-8742) or visit here.