Transoral Incisionless Fundoplication (TIF)
A Surgical Solution for Heartburn Without Incisions – “Transoral Incisionless Fundoplication
What may have seemed like science fiction, surgery without an incision, is now a reality that is giving back patients suffering from chronic acid reflux or gastroesophageal reflux disease (GERD) a normal life. Dr. Haidry at the LGC is now offering the TIF procedure for the treatment of GERD. He was the first endoscopist in Europe to perform the TIF 2.0 procedure and has the most experience with this new procedure in Europe having carried out the most cases.
In a healthy patient, there is a natural valve between the esophagus and the stomach that forms a physical barrier preventing stomach fluids from backwashing, or “refluxing,” up into the esophagus. In a patient with chronic GERD, this valve has become dysfunctional.
Many patients take reflux medications such as PPIs (proton pump inhibitors), which suppress acid production, to help relieve their heartburn symptoms. Even with PPIs, they are still unable to eat the foods they want or need to sleep sitting up to reduce nighttime reflux. In addition, recent studies have shown that long-term use of PPIs is linked to inadequate absorption of minerals1, chronic kidney disease2 and dementia3. GERD sufferers just want to get back to living normal lives.


The TIF procedure restores the integrity of the gastroesophageal valve, the natural barrier to reflux, by creating, internally, a 270-degree Oesophagogastric wrap around the distal esophagus, anchored by multiple polypropylene fasteners. The procedure is performed through the mouth with flexible, tube-like instrument, called the EsophyX Z+ device which holds the gastroscope for the vision.
Who can benefit from TIF?
- Patients with typical acid reflux symptoms (GORD) and sub-optimal control of their symptoms on PPIs who do not have a large hiatal hernia (<3cm) or oesophageal motility problems
- Patients with GORD symptoms and mild to moderate anatomic abnormalities of the gastroesophageal junction valve function that require correction
- Patients preferring an alternative management strategy for their GORD that does not involve long-term medication use
- Trouble swallowing
- Difficulty eating for several months
- Trapped air resulting in belching or bloating
- Hernia at the incision location

TRANSORAL INCISIONLESS FUNDOPLICATION – the TIF procedure, fills the refractory GERD treatment gap. Using an endoscopic approach – similar to diagnostic EGD – the gastroesophageal valve (GEV) is reconstructed without incisions following principles of traditional fundoplication. The TIF procedure maintains an exemplary safety profile with minimal side-effects.
TIF Talk With Dr Rehan Haidry
TIF Procedure
Please contact the London Gastroenterology Centre if you or someone you know suffers with chronic GERD and would like more information about how the TIF procedure can get you back to living without the pills and without heartburn.
- http://www.fda.gov/drugs/drugsafety/informationbydrugclass/ucm213259.htm
- Lazarus B, et. al., JAMA Intern Med. 2016 Feb 1;176(2):238-46.
- Gomm W et. al., JAMA Neurol. 2016 Feb 15. doi: 10.1001/jamaneurol.2015.4791.


To make an enquiry or appointment please contact Dr Rehan Haidry's secretary