When Is Surgical Intervention Appropriate?
When GERD has progressed to a level where conventional therapies are no longer satisfactory, surgical intervention may be warranted to correct the underlying anatomical cause of GERD, the defective antireflux valve. Over the last 50 years, the procedure has evolved from an open to a laparoscopic procedure, and recently to a new incisionless procedure. .
Laparoscopic reconstruction of the antireflux valve has been shown to be effective in 75 to 90 percent of patients in alleviating heartburn and 50 to 75 percent in alleviating cough, asthma, and laryngitis. Studies and years of clinical use prove that an anatomical correction is key to long-term prevention of GERD and disease progression.
However, even laparoscopic surgical repair can be invasive, requiring from three to four small abdominal incisions, and typically has a high incidence of side effects like gas bloat and difficulty swallowing. For this reason, fewer than one percent of GERD patients choose invasive surgical therapy to treat their condition.
The new incisionless procedure called TIF (Transoral Incisionless Fundoplication), made possible by the innovative EsophyX device, is performed through the patient's mouth, or "transorally." TIF is the third wave in the evolution of surgical procedures for the treatment of GERD and builds upon the principles of open and laparoscopic surgical procedures and is only minutely invasive. TIF delivers similar benefits as the time-proven laparoscopic antireflux procedure. The key differences are that TIF reconstructs the antireflux valve through the mouth, does not require incisions, and does not dissect any part of the natural internal anatomy. Recovery and discomfort are reduced and most patients are able to return to work and normal activities within a couple of days following the procedure.
The new incisionless GERD surgical procedure, called TIF, is performed through the patient's mouth (called "transoral" in medical terminology), rather than through three or four external incisions.
