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Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
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Transoral Incisionless Fundoplication.

Kenneth J Chang1, Reginald Bell2

  • 1Gastroenterology and Hepatology Division, H.H. Chao Comprehensive Digestive Disease Center, University of California, Irvine Medical Center, 101 The City Drive, Orange, CA 92868, USA.

Gastrointestinal Endoscopy Clinics of North America
|March 10, 2020
PubMed
Summary
This summary is machine-generated.

Trans-oral incisionless fundoplication (TIF 2.0) offers a minimally invasive endoscopic solution for GERD by reshaping the esophagogastric junction. This procedure effectively reduces reflux and minimizes the gas-bloat side effect common with other anti-reflux surgeries.

Keywords:
EsophagitisFundoplicationGastroesophageal refluxHiatal herniaHumansLaparoscopyProton pump inhibitorsTreatment outcome reflux

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Endoscopic Therapeutics

Background:

  • Gastroesophageal reflux disease (GERD) is a complex condition requiring individualized treatment based on patient anatomy.
  • Traditional surgical options for GERD can have significant side effects, such as the gas-bloat syndrome.

Purpose of the Study:

  • To discuss the rationale, mechanism, and application of Trans-oral incisionless fundoplication (TIF 2.0) for GERD management.
  • To review the safety, efficacy, and potential future indications of the TIF 2.0 procedure.

Main Methods:

  • TIF 2.0 is an endoscopic procedure performed via the trans-oral route.
  • It involves creating a partial fundoplication at the esophagogastric junction (EGJ) using a specialized device.
  • The procedure aims to reduce EGJ distensibility and establish a high-pressure zone to prevent reflux.

Main Results:

  • TIF 2.0 effectively reduces esophagogastric junction distensibility and transient lower esophageal sphincter relaxations (tLESRs).
  • The procedure creates a 3-cm high-pressure zone, acting as a flap valve to impede reflux.
  • Partial fundoplication allows for gas escape, significantly minimizing the risk of gas-bloat syndrome.

Conclusions:

  • TIF 2.0 provides a safe and effective endoscopic alternative for GERD treatment, particularly for patients with specific anatomic considerations.
  • The procedure's ability to preserve gas passage offers a distinct advantage over traditional surgical methods.
  • Further research into concomitant use with hernia repair and expanded indications is warranted.