Gastroesophageal reflux disease

Information, Symptoms, Treatments and Resources

EsophyX TIF procedure for GERD

By Dr. Elliot R. Goodman


Now there is an effective, long-term solution for people suffering from GERD (gastroesophageal reflux disease) who are ...

  • Dissatisfied with pharmaceutical therapies
  • Experiencing heartburn or non-heartburn symptoms of GERD
  • Concerned about long-term effects of a lifetime of taking pills

Q: What is the EsophyX TIF procedure?


A giant leap in the evolution of the treatment of GERD, also known as chronic acid reflux disease, the revolutionary EsophyX TIF (Transoral Incisionless Fundoplication) procedure treats the root cause of GERD, an anatomic deficiency at the gastroesophageal junction. The EsophyX surgical device is used to perform the TIF procedure to reconstruct the antireflux valve and restore the body’s natural protection against reflux.


Q: What is the procedure like?


A completely incisionless procedure, the EsophyX TIF procedure is performed safely, quickly, and with minimal patient downtime. The procedure is called a Natural Orifice Surgery (NOS) procedure because the EsophyX device is introduced into the body through the mouth, rather than through an abdominal incision. The advantages of incisionless surgery over conventional laparoscopic or open GERD surgery include shorter hospital stay, reduced patient discomfort, shortened patient recovery, no visible scars, and typically higher patient satisfaction.


Q: How is the procedure performed?


Performed with the patient under general anesthesia, the EsophyX device is introduced into the body transorally (through the mouth) and advanced into the esophagus under visualization of a video camera inserted down the central shaft of the device. The EsophyX device is then used to form and fasten several tissue folds, or plications, to create a robust antireflux valve at the gastroesophageal junction, resulting in the effective elimination of GERD. Most patients go home the next day and can return to work and most normal activities within a few days. In the weeks following surgery, a natural healing process fuses and cements the plications to create a durable antrireflux barrier.



(1) The specially designed EsophyX device enters the esophagus through the mouth and is positioned at the junction of the stomach and esophagus. 


(2) The device forms and fastens tissue folds to create a valve, recreating natural anatomy.



Q: How long does the procedure take?


The procedure itself will generally take less than one hour.


Q: What is the recovery like?


Most patients can return to work the next day or within a few days following their EsophyX TIF procedure.  Patients should expect to experience some discomfort in their chest, nose and throat for the first few days to a week. Patients will be asked to restrict physical activity for the first week and will be given dietary guidelines to help maximize their success while the tissue heals.


Q: What results should I expect?


In recent studies, EsophyX patients reported 80% improvement in quality of life, significantly improved satisfaction, and reduction/elimination of heartburn symptoms. All patients discontinued medication after the EsophyX procedure and 79% were still completely off daily medication two years after the procedure.


Q: Is the procedure safe?


EsophyX TIF has been proven safe in use in hundreds of procedures worldwide. To date, side effects have been minimal.


Q: What is the difference between EsophyX TIF and pharmacological therapy?


TIF is the first procedure that provides an incisionless anatomical solution to a disease that today is typically treated with acid antisecretory medications, either PPIs (proton pump inhibitors) or histamine receptor antagonists (H2 blockers). But GERD is a progressive disease, and the pharmaceuticals typically lose their effectiveness over time. GERD sufferers today are also concerned about the well-known adverse effects of long-term use of PPIs, including osteomalacia (inadequate absorption of calcium and other minerals into the bones, essential to bone health). Since pharmacological therapy does not treat the underlying root causes of reflux, the deteriorated anatomy of the antireflux barrier, life-long medication therapy is required. Add to all that such lifestyle changes as special daily diets and pill regimens and having to reduce or eliminate activities like playing sports. 


Q: What are my treatment options?


In addition to dietary controls, you and your doctor have options including pharmaceuticals, surgical options, and EsophyX TIF, an incisionless surgical solution. 


  • Pharmaceuticals: While pharmaceuticals alleviate the symptoms, they don’t solve the underlying anatomical problem and generally don’t stop disease progression. Over time you may need to increase your dosage and, like many GERD sufferers, it may mean taking medication for the rest of your life. What’s more, recent major studies on the adverse effects of long-term use of PPIs show increased risk of bone fractures.
  • Conventional surgical options: Invasive surgical procedures have long been known to be an effective long-term solution to treating GERD. During the surgery, the valve is reconstructed by wrapping the upper portion of the stomach around the esophagus.
  • Incisionless EsophyX TIF: Based on may years of proven surgical concepts and techniques, EsophyX is the first incisionless NOS (Natural Orifice Surgery) procedure to emulate gold-standard conventional surgery procedures.


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