Comparison of the TIF Procedure and Traditional Antireflux Surgery

Antireflux Surgery[1-5]

The goal of antireflux surgery is to restore the normal functions of the junction between the esophagus and the stomach. This is carried out by wrapping the upper portion of the stomach (the fundus) around the esophagus, either partially or totally.  Both the TIF procedure and traditional antireflux surgery have the same goal.

Benefits of the TIF procedure:

  • No scars, due to incisionless approach
  • Faster recovery, since there is no internal cutting of the natural anatomy
  • Fewer adverse events and complications than conventional surgery
  • Can be revised if required

The purpose of the surgery is to:

  • Reduce a hiatal hernia (if present) by repairing the enlarged opening in the diaphragm
  • Ensure proper positioning of the stomach and esophagus below the diaphragm
  • Restore the angle at which the esophagus enters the stomach
  • Increase the pressure of the LES (lower esophageal sphincter) to prevent reflux and restore one-way valve operation

Treatment Options

Among the treatments available to people with severe GERD-related symptoms, the more advanced options are the TIF procedure and traditional antireflux surgery.

Traditional, or conventional, antireflux surgery has been long considered an effective solution for treating GERD. The surgery involves several abdominal incisions and typically includes side effects such as difficulty swallowing (26%), bloating (36%), and increased flatulence (65%).

The TIF (Transoral Incisionless Fundoplication) procedure for chronic acid reflux treats the underlying cause of GERD without incisions. This procedure rebuilds the antireflux valve and restores the body’s natural protection against reflux.  It follows the well-established principles of conventional antireflux surgery and delivers similar results in an innovative way.

Comparison of the TIF Procedure and Traditional Antireflux Surgery

The main differences between the TIF procedure and traditional antireflux surgery are:

  • No Incisions:  Conventional antireflux surgery involves accessing the anatomy via 3-5 abdominal incisions. The TIF procedure does not require any incisions as it is performed through the patient’s mouth. This difference leads to less patient discomfort.
  • No Dissection: Certain antireflux surgeries require the surgeon to cut around anatomy, which can increase the risk of complications and adhesions and can prolong recovery time.  The TIF procedure does not require cutting.
  • Excellent Safety Profile: To date, more than 18,000 TIF procedures have been performed with fewer complications than conventional antireflux surgery.

Due to the unique approach of the TIF procedure, you will most likely be able to return to work and normal activities within a few days after your TIF procedure. This lets you get back to your life sooner, free of the distraction and discomfort of GERD.


[1] Varin, O., et al. Total vs Partial Fundoplication in the Treatment of Gastroesophageal Reflux Disease:A Meta-Analysis. Arch Surg. 2009; 144(3): 273-278.
[2] Jobe, B.A., et. al. Endoscopic Appraisal of the Gastroesophageal Valve After Antireflux Surgery. Am J of Gastro 2004.
[3] Little, A., et. al. Mechanisms of Action of Antireflux Surgery: Theory and Fact. World J of Surg. 1992;16:320-5.
[4] Nissen R, The Treatment of Hiatal Hernia and Esophageal Reflux by Fundoplication. Hernia 1964;30:488-496.
[5] Adler, R.H., et. al. A valve mechanism to prevent gastroesophageal reflux and esophagitis. Surgery 1958;44:63-75.

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