Transoral Incisionless Fundoplication (TIF)
What is TIF?
Transoral incisionless fundoplication (TIF) is an advanced endoscopy procedure to treat gastro-oesophageal reflux disease (GORD) and LPR (laryngopharyngeal reflux, sometimes referred to as silent reflux).
When a person experiences reflux issues it means the contents of the stomach (partially digested food, stomach acid and bile) leak up the food pipe (the oesophagus). It may be described by doctors as heartburn, reflux or regurgitation and is defined as chronic reflux when it is happening frequently (rather than an occasional nuisance).
Over time reflux can damage the oesophagus – up to 15% patients will go on to develop a pre-cancerous condition called Barrett’s Oesophagus. This means that the repeated exposure to stomach acid causes changes to the cell lining and the longer a person has reflux, the higher their possibility of Barrett’s and oesophageal cancer.
This is why many GORD and LPR patients are looking at permanent solutions to prevent acid reflux. Dr Rehan Haidry is an experienced Consultant Gastroenterologist and interventional endoscopist, considered one of the country’s leading experts in reflux issues, and was the first doctor in Europe to offer TIF, a pioneering alternative to conventional anti-reflux surgery.
Surgery or TIF?
During anti-reflux surgery (commonly performed on the NHS for patients with GORD or Barrett’s Oesophagus) incisions are made in the abdomen and the surgeon wraps the stomach around the lowest portion of the food pipe to control reflux/regurgitation into the oesophagus (which means the cell lining damage is reduced and therefore the risk of oesophageal cancer developing).
However this surgery is not without its side effects – the patient also loses the ability to belch (thereby increasing bloating/flatulence) and vomit which some patients find distressing. Some encounter swallowing issues.
Transoral incisionless fundoplication (TIF) is an advanced endoscopy procedure where Dr Haidry mimics what the surgeons do but in a minimally invasive way. It is all performed via endoscope and takes less than 30 minutes.
The bottom of the food pipe is pushed into the stomach and stitched into place creating a new ‘anti reflux valve’ for the patient that prevents stomach contents leaking up. Unlike anti-reflex surgery the patient can still burp/vomit which many patients find reassuring.
TIF recovery is quick – most people are back home within 1 day and back at work within 4 days and it’s very safe, less than 0.5% patients will experience a serious problem.
Studies have shown that for up to five years after the TIF procedure, GORD symptoms are significantly reduced and around 80% of patients can stop taking daily heartburn drugs. In a recent study published from John Hopkin hospital in USA, 49 patients with LPR and evidence of GORD had the TIF procedure and experienced an improvement in their symptoms.
The TIF procedure reduces the chronic acid reflux and reduces the harm to the cell lining (which may have turned cancerous over time).
TIF
- TIF mimics what surgeons do, but it’s completely incisionless (performed via endoscopy)
- TIF takes around 30 minutes and doesn’t require surgery
- TIF patients maintain normal functions such as the ability to belch and vomit
- There is very little risk of swallowing problems (1%) after the TIF procedure
SURGERY
- Surgery involves multiple incisions in the patient’s abdomen
- Surgery takes significantly longer
- Patients lose the ability to vomit, which some patients find distressing, and burping/belching function can be limited.
- Surgery typically includes side effects such as difficulty swallowing (10-15%), bloating, and increased flatulence
- Surgery is the best option for those with large hiatal hernias
22,000 TIF procedures have been carried out worldwide with minimal complications and a serious adverse event rate under 0.5%.
TIF can help eliminate general GORD symptoms including upper abdominal pain, nausea/vomiting, stomach bleeding and swallowing disorders. It can also help with “atypical” symptoms of such as worsening asthma, hoarseness, cough, chest pain, aspiration or a ‘lump in the throat’ sensation which medicines haven’t been very effective in treating.
The TIF procedure is currently available at the Cleveland Clinic Hospital in London and is covered by most private insurers.
Get In Touch
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:
Tel: 0203 423 7609 | Email: rhaidrymedsec@ccf.org