Incisionless surgery for chronic heartburn or acid reflux treatment in Richmond, Virginia

Los Robles Regional Medical Center is proud to offer transoral incisionless fundoplication (TIF)—the latest treatment for effectively treating chronic acid reflux disease, also known as gastroesophageal reflux disease (GERD). A completely incisionless procedure, TIF reconstructs the anti-reflux barrier to provide a solution to the anatomical root cause of GERD. The procedure is for patients who are dissatisfied with current pharmaceutical therapies or are concerned about the long-term effects of daily use of reflux medications.

Contact us

To find a physician or speak with a nurse for GERD treatment, please call our Consult-A-Nurse® line at (877) 888-5746.

TIF was developed to emulate more invasive surgical techniques, but without incisions and visible scars. Surgeons perform TIF using the innovative EsophyX surgical device from EndoGastric Solutions, which typically lasts no more than 50 to 60 minutes.

The procedure is performed under general anesthesia and reconstructs the antireflux barrier to restore the competency of the gastroesophageal junction. Most patients can go home the next day and return to work within a few days. In clinical studies, 79 percent of patients remained off daily proton pump inhibitors (PPIs) and 93 percent experienced a total elimination of heartburn at two years after the TIF procedure.

What is GERD?

Diagram of an inflamed chest and esophagus

If you have heartburn or reflux twice a week or more, you may have GERD. Heartburn is the most common symptom, but you may also experience:

  • Hoarseness or sore throat
  • Frequent swallowing
  • Asthma or asthma-like symptoms
  • Pain or discomfort in the chest
  • Sleep disruption (unable to sleep lying down)
  • Bloating
  • Excessive clearing of the throat
  • Persistent cough
  • Burning in the mouth or throat
  • Intolerance of certain foods
  • Dental erosions or therapy-resistant gum disease or inflammation

Normally, after swallowing, a valve between the esophagus and stomach opens to allow food to pass, and then it closes to prevent stomach contents from "refluxing" back into the esophagus, which causes a burning sensation in the chest. For people who suffer from GERD, the valve is dysfunctional and unable to prevent acid from refluxing into the esophagus.

TIF Step-by-step

Step one

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

Step two

The EsophyX device pulls and fastens a tissue fold.

Step three

Step two is repeated multiple times to reconstruct a robust, tight gastroesophageal valve (GEV) that prevents the reflux of stomach fluids up into the esophagus. This results in the effective elimination of GERD.

What is the best long-term solution for GERD treatment?  

GERD is typically treated with medications such as histamine receptor antagonists (H2 blockers) like Pepcid®, Tagamet® and Zantac® as well as proton pump inhibitors (PPIs) like Nexium®, Prilosec and Protonix®. These medications can lose their effectiveness over time and they do not treat the underlying root cause of reflux. Additionally, recent studies on the adverse effects of long-term use of PPIs indicate a significantly higher incidence of hip fractures, particularly among women.

Conventional Surgical Treatment for GERD

For people who have severe GERD, surgical intervention may be required. Although the conventional laparoscopic procedure is a very effective long-term solution, it is still "invasive" because patients must remain in the hospital for up to several days. For that reason, the number of GERD sufferers who undergo the procedure is relatively small.