Endoscopic GERD therapy: a primer to the transoral incisionless fundoplication procedure.

Abstract Patients with medically refractory gastroesophageal reflux disease (GERD) have the option of surgery but may opt for effective minimally invasive interventions, when available. However, the primary GERD pharmacological therapy, proton pump inhibitors, does not satisfactorily address the pathophysiology of the disease. Moreover, a therapeutic gap exists in those severely symptomatic patients who fail medical… Read more »

pH Scores in Hiatal Repair with Transoral Incisionless Fundoplication

Background and Objectives: Transoral incisionless fundoplication is an alternative to traditional laparoscopic fundoplications. Recently, hiatal hernia repair combined with transoral incisionless fundoplication has become an accepted modification of the original procedure; however, outcomes information, particularly objective pH monitoring, has been sparse. We retrospectively review the subjective and objective outcomes of transoral incisionless fundoplication combined with… Read more »

Endoscopic foregut surgery and interventions: The future is now. The state-of-the-art and my personal journey

In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic, the content will progress as follows: “lessons learned”, “technical considerations” and “future opportunities”. Lessons learned will provide a… Read more »

Long-term reported outcomes of transoral incisionless fundoplication: an 8-year cohort study

BACKGROUND: Transoral incisionless fundoplication (TIF) offers an endoscopic approach to the treatment of gastroesophageal reflux disease (GERD). Controlled trials have demonstrated the short-term efficacy of this procedure, but long-term follow-up studies are lacking. The objective of this study was to evaluate the long-term impact of TIF on disease-specific quality of life and antisecretory medication use.… Read more »

The Spectrum of Surgical Remediation of Transoral Incisionless Fundoplication-Related Failures

AIM: To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). METHODS: This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized… Read more »

Transoral incisional fundoplication for reflux after peroral endoscopic myotomy: a crucial addition to our arsenal

INTRODUCTION: Increased esophageal acid exposure is seen in a large percentage of patients with achalasia who undergo peroral endoscopic myotomy (POEM). Endoscopic transoral fundoplication (TIF) is a novel endoscopic technique for the management of patients with chronic gastroesophageal reflux (GERD). We present the first case series evaluating the role of TIF post-POEM. METHODS: Consecutive patients… Read more »

Transoral fundoplication for gastroesophageal reflux disease

Transoral incisionless fundoplication (TIF) has recently been proved to be an effective therapeutic option as an alternative to medical and surgical therapy. TIF reconfigures the tissue to obtain a full-thickness gastro-esophageal valve from inside the stomach, through serosa-to-serosa plications including the muscle layers. Current issues about TIF refer to: (I) the capability of the procedure… Read more »