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Transoral incisionless fundoplication, laparoscopic hiatal hernia repair and GERD

Tue, 07/21/2020 - 17:12
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A review article in Therapeutic Advances in Gastroenterology describes the refinement of EsophyX technology (EndoGastric Solutions) and the evolution of transoral incisionless fundoplication (TIF) as a safe and effective treatment for patients with gastroesophageal reflux disease (GERD). The article, ‘The evolution of TIF: transoral incisionless fundoplication’, authored by Dr Glenn Ihde from the Matagorda Medical Group in Bay City, TX, provides an overview of current best practices with respect to TIF 2.0 as a stand-alone procedure as well as in conjunction with hiatal hernia (HH) repair.

TIF was initially developed as an incisionless procedure, but as the EsophyX technology has become easier to use and yields more reproducible outcomes, a growing number of surgeons have combined it with laparoscopic hiatal hernia repair (LHHR) to provide durable relief of GERD symptoms to a broader patient population who may have anatomic defects that require correction beyond TIF.

“A robust and growing body of clinical data demonstrates that TIF as a stand-alone procedure or TIF performed with HH repair provides effective and durable relief of symptoms without many of the side effects associated with traditional anti-reflux procedures,” said. Ihde. “Both straight TIF and TIF in conjunction with HH repair have been shown to improve quality of life and allow most patients to completely come off or significantly reduce their proton pump inhibitor (PPI) medications, which are not intended for long-term usage. The article is intended to provide gastroenterologists and surgeons with up-to-date information that they can use to support their clinical decision-making in the treatment of GERD.”

Key data highlighted in the publication includes the following:

  • Refinements in technology and technique surrounding the TIF 2.0 procedure with EsophyX Z+ have led to improved ease of use, continued exemplary safety profile and more reproducible outcomes
  • With refinements to the TIF procedure, TIF 2.0 is identified as morphologically and physiologically similar to the gold standard Nissen fundoplication, without the common side effects such as postoperative dysphagia, bloat, gassiness and flatulence
  • Patients with a HH of less than 2 cm can often be treated with the TIF 2.0 procedure alone
  • The TIF 2.0 with HH repair can now be performed on a broader spectrum of patients, including those with a larger HH and more advanced disease

“In recent years, growing patient concerns about the long-term safety issues associated with chronic use of PPI medications have created the need for new treatment options,” said Dr Jonathan a gastroenterologist at The Frist Clinic in Nashville, part of TriStar Medical Group. “This procedure allows gastroenterologists to offer an individualized patient care plan or partner with surgeons to treat a broader spectrum of patients suffering from GERD.”

“Dr Idhe’s review provides important context to the evolution of both the EsophyX device and the TIF 2.0 procedure,” said Skip Baldino, President and CEO of EndoGastric Solutions. “With more than 20 percent of the US population suffering from GERD, we are proud to be able to provide doctors with an effective, safe, and minimally invasive solution to address and treat a larger patient population.”

To access this paper, please click here