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TIF® Procedure

The Transoral Incisionless Fundoplication (TIF®) procedure using EsophyX® technology is a minimally invasive treatment for gastroesophageal reflux disease (GERD). It works by reconstructing the valve at the base of the esophagus as well as reducing a hiatal hernia to create a tighter opening that can prevent stomach reflux. This innovative procedure uses a transoral approach, which can completely eliminate reflux symptoms in some patients. By using this advanced approach, the device is inserted through the mouth to access the stomach, and no incisions are used.


For optimal GERD treatment and minimal side effects, our doctors will carefully select candidates who are likely to achieve successful results. In general, this includes patients who can identify with the following:

In addition, patients should not have any medical conditions that could affect post-operative healing. More personalized details about an individual’s candidacy will be discussed during the consultation process.

The TIF® Procedure

The TIF® procedure is performed under general anesthesia in an outpatient setting. It utilizes EsophyX® technology that has been specially designed for altering the esophageal valve to create a partial fundoplication. This involves wrapping the upper portion of the stomach around 270 degrees of the esophagus.

To begin the procedure, a flexible endoscope is inserted into the EsophyX® device, which allows the surgeon to visualize every step of the process. The device is then gently inserted through the mouth and guided into the stomach. Due to this transoral approach, no incisions are created. The stomach is then inflated, creating space for the device and endoscope to be retroflexed back towards the esophagus.

The EsophyX® tool then pulls the gastroesophageal junction down into its tissue mold, and the device is slightly rotated. During this time, a small hiatal hernia can be reduced using suction created by the device. To secure this retracted tissue to the outside of the esophagus, non-absorbable fasteners (composed of strong polypropylene material) are placed in pairs around the valve. Approximately 20 fasteners are typically required. This process of retracting, rotating, and securing the tissue is repeated until an omega-shaped valve is created.

Recovery and Results

Since no incisions are needed during the TIF® procedure, post-operative wound care is not involved during the recovery. Over the course of the following weeks, fibrous tissue develops in the area, and the tissue surrounding the valve fuses, helping secure a full thickness partial fundoplication. The valve created by the TIF® procedure has proven effective and durable in long-term clinical studies. In addition, the approach has shown to result in fewer complications than traditional acid reflux procedures. When performed on ideal candidates, the TIF® procedure has been reported to completely eliminate GERD symptoms.