AIM: To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). METHODS: This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized… Read more »
Transoral fundoplication for gastroesophageal reflux disease
Transoral incisionless fundoplication (TIF) has recently been proved to be an effective therapeutic option as an alternative to medical and surgical therapy. TIF reconfigures the tissue to obtain a full-thickness gastro-esophageal valve from inside the stomach, through serosa-to-serosa plications including the muscle layers. Current issues about TIF refer to: (I) the capability of the procedure… Read more »
Transoral Incisionless Fundoplication (TIF 2.0): A Meta-Analysis of Three Randomized, Controlled Clinical Trials.
Abstract: The TIF procedure has emerged as an endoscopic treatment for patients with refractory gastro-esophageal reflux disease (GERD). Previous systematic reviews of the TIF procedure conflated findings from studies with modalities that do not reflect the current 2.0 procedure technique or refined data-backed patient selection criteria. A meta-analysis was conducted using data only from randomized… Read more »
Management options for patients with GERD and persistent symptoms on proton pump inhibitors: recommendations from an expert panel
BACKGROUND: The aim of this study was to assess expert gastroenterologists’ opinion on treatment for distinct gastroesophageal reflux disease (GERD) profiles characterized by proton pump inhibitor (PPI) unresponsive symptoms. METHODS: Fourteen esophagologists applied the RAND/UCLA Appropriateness Method to hypothetical scenarios with previously demonstrated GERD (positive pH-metry or endoscopy) and persistent symptoms despite double-dose PPI therapy… Read more »
Efficacy of transoral incisionless fundoplication for refractory gastroesophageal reflux disease: a systematic review and meta-analysis
BACKGROUND: Given poor symptomatic response rates and rising awareness of the adverse events associated with the long-term use of proton pump inhibitors (PPIs), endoscopic modalities for treatment of refractory gastroesophageal reflux disease (GERD) have become more prominent. The aim of this study was to perform a systematic review and meta-analysis to evaluate feasibility, efficacy, and… Read more »
The TEMPO Trial at 5 Years: Transoral Fundoplication (TIF 2.0) Is Safe, Durable, and Cost-effective
Background. Questions remain about the therapeutic durability of transoral incisionless fundoplication (TIF). In this study, clinical outcomes were evaluated at 5 years post-TIF 2.0. Methods. A total of 63 chronic gastroesophageal reflux disease (GERD) sufferers with troublesome symptoms refractory to proton pump inhibitor (PPI) therapy, absent or ≤2 cm hiatal hernia, and abnormal esophageal acid… Read more »
Trans-oral incisionless fundoplication vs stretta, two recognized endoluminal anti-reflux therapies; a systematic review and meta-analysis
Gastro-oesophageal reflux disease (GORD) is common with a prevalence of 10-20% in the Western World. During the last two decades, amongst introduced several endo-luminal techniques, evidence has emerged about the efficacy and safety of two treatment modalities for GORD; ‘Stretta’ procedure and trans-oral incisionless fundoplication (TIF)’ or EsophyX. Author in this study aim to conduct… Read more »
Efficacy of Laparoscopic Nissen Fundoplication vs Transoral Incisionless Fundoplication or Proton Pump Inhibitors in Patients With Gastroesophageal Reflux Disease: A Systematic Review and Network Meta-analysis
BACKGROUND & AIMS: The effects of transoral incisionless fundoplication (TIF) and laparoscopic Nissen fundoplication (LNF) have been compared with those of proton pump inhibitors (PPIs) or a sham procedure in patients with gastroesophageal reflux disease (GERD), but there has been no direct comparison of TIF vs LNF. We performed a systematic review and network meta-analysis… Read more »
Transoral incisionless fundoplication for Jehovah’s Witnesses: A case report discussing safety and durability
Jehovah’s Witness patients pose a unique surgical challenge due to their refusal of transfusion of whole blood or major blood products. One of the surgical strategies is to offer the least invasive approach with the least likelihood of losing blood. In the context of surgical treatment of gastroesophageal reflux disease, endoluminal approaches such as transoral… Read more »
Endoscopic anti-reflux devices (with videos)
BACKGROUND GERD is one of the most common GI diseases, accounting for 7 million annual outpatient visits in the United States.1 Lifestyle modification and medical therapy, including acid-suppressive medications, are first-line treatments for GERD.2,3 In approximately 30% to 40% of patients with GERD, medical therapy provides only partial relief of symptoms.4 Laparoscopic anti-reflux surgery remains… Read more »