Transoral Incisionless Fundoplication

Gastrointest Endosc Clin N Am. 2020 Apr;30(2):267-289. doi: 10.1016/j.giec.2019.12.008. Epub 2020 Feb 13.

Abstract

GERD is a spectrum disorder, and treatment should be individualized to the patient's anatomic alterations. Trans-oral incisionless fundoplication (TIF 2.0) is an endoscopic procedure which reduces EGJ distensibility, thereby decreasing tLESRs, and also creates a 3-cm high pressure zone at the distal esophagus in the configuration of a flap valve. As it produces a partial fundoplication with a controlled valve diameter, gas can still escape from the stomach, minimizing the side-effect of gas-bloat. Herein we discuss the rationale, mechanism of action, patient selection, step-by-step procedure, safety and efficacy data, it's use with concomitant laparoscopic hernia repair, and future emerging indications.

Keywords: Esophagitis; Fundoplication; Gastroesophageal reflux; Hiatal hernia; Humans; Laparoscopy; Proton pump inhibitors; Treatment outcome reflux.

Publication types

  • Review

MeSH terms

  • Female
  • Fundoplication / methods*
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Mouth / surgery
  • Natural Orifice Endoscopic Surgery / methods*
  • Stomach / surgery
  • Treatment Outcome