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Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents flow back into the esophagus (tube passage between the mouth and the stomach) causing heartburn, a burning sensation in the chest.

There are about 30 million Americans or 10 percent of the population who suffer daily from symptoms of heartburn or acid reflux, which include difficulty swallowing, sore throat, coughing and dental problems. Most of these victims are dependent on medication.

The advent of laparoscopy, which contrary to performing long abdominal incision in open surgery is done only with 3 to 6 buttonhole-size opening, is giving hope for millions to get lasting, mild surgical solution for acid reflux. However, most GERD patients are still deterred from getting an anatomic repair for fear of complications since laparoscopy, though minimally invasive, still involves cutting tissues in the body.

Transoral Incisionless Fundoplication (TIF), using a FDA-cleared device, repairs the problematic stomach-esophagus junction by way of the mouth. Hiatal hernia, which is the bulging out of the upper part of the stomach towards the esophagus, causes stomach acid to go back up. Abnormal relaxation of the muscles responsible for closing the top of the stomach may also cause the reflux.

Unlike laparoscopic fundoplication and open surgery, which cut into the skin and internal organs, a single insertion of the endoscope carrying the TIF device into the oral passageway pulls back the hernia into its original anatomical position. The TIF device then folds a part of the stomach tissue to create a valve between the stomach and esophagus, preventing the outflow of gastric contents.
Because TIF is incisionless, there is reduced pain, minimal downtime, shorter recovery period and no visible scar. TIF is also reversible and repeatable.
In a study published in the World Journal of Surgery involving 86 patients between 19 to 73 years old who were on continuous daily Proton-Pump Inhibitors (PPIs), 80 percent of patients reported improved quality of life and discontinuation of medications at 12 months after the procedure.
The TIF is recommended as an option for patients who have persistent symptoms even with medications or have concerns about cost and the side effects of pill therapy.

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