Minimally Invasive Transoral Surgery Treats Heartburn

A surgical procedure called transoral incisionless fundoplication (TIF) offers an alternative to patients suffering from gastroesophageal reflux disease (GERD) for whom daily treatments with proton pump inhibitors (PPIs) is inadequate.

The procedure is performed using the EsophyX device, an innovative natural orifice surgery (NOS) device to treat GERD that creates a robust 2 cm - 3 cm, 270° - 320° transoral esophagogastric fundoplication. The device is comprised of a tissue mold and chassis used to compress and wrap tissue around esophagus; a helical retractor that anchors, retracts, and elongates tissue by radial manipulation, which is positioned inside the tissue mold during insertion and removal; an invaginator for circumferential retraction of esophageal tissue that allows reduction and elimination of a hiatal hernia of up to 2 cm; and stylets and fasteners to maintain tissue compression throughout healing process.


The EsophyX device is introduced transorally and advanced into the esophagus under visualization of a video camera inserted down the central shaft of the device. It is then used to form and fasten several tissue folds (plications), creating a robust antireflux valve at the gastroesophageal junction and tightening the lower esophageal sphincter (LES), thus reestablishing a barrier to reflux and restoring the competency of the gastroesophageal junction. Advantages of TIF incisionless surgery over conventional laparoscopic or open GERD surgery include shorter hospital stay, reduced patient discomfort, shortened patient recovery, no visible scars, and typically higher patient satisfaction. The EsophyX device is a product of Endogastric Solutions (Redmond, WA, USA).

"The TIF procedure recreates the antireflux barrier between the esophagus and stomach and is performed transorally,” said Benjamin Havemann, MD, a gastroenterologist at Scott & White Healthcare - Round Rock (Temple, TX, USA). "The procedure can reduce a small hiatal hernia and creates a valve between the stomach and esophagus restoring the natural, physiological anatomy to prevent reflux. Because the procedure is incisionless, there is reduced pain, shorter recovery time required, and no visible scar.”

Related Links:
Endogastric Solutions
Scott & White Healthcare - Round Rock