Surgery without incisions for heartburn

The procedure is called the Transoral Incisionless Fundoplication, or TIF, which uses the EsophyX® device and is performed without incisions.

"Most patients who have chronic heartburn or GERD find that their condition is well controlled with medications like PPIs; the TIF procedure, on the other hand, is an option for those patients who do not do well on daily medications or those who have concerns about the implications of lifelong pill therapy like cost and side effects," said F. Paul "Tripp" Buckley, III, MD, general surgeon at Scott & White -- Round Rock. "For the right patient, TIF can improve quality of life and having a multi-disciplinary, integrated team of specialists in place at Scott & White also allows for the highest quality medical care for the patient," said Dr. Buckley. "Scott & White is unique in that we have a surgeon and a gastroenterologist working side-by-side as a team to perform the procedure."

Dr. Buckley goes on to explain, "Gastroesophageal Reflux Disease (GERD) is a mechanical/anatomic problem and reflux medication like PPIs help relieve the majority of patients' heartburn symptoms. Some patients, however, continue to have symptoms despite maximum medical therapy. Others may have complications, and or, contraindications to long-term PPI use, while some patients don't want to be on lifelong medications or can't afford them. For these patients, a mechanical fix is needed. And, traditionally, this has meant a major surgical procedure (most commonly a laparoscopic Nissen Fundoplication). With the advent of the TIF procedure, the traditional surgery can be duplicated without any incisions."

Laparoscopy, a form of "minimally invasive surgery," typically requires from three to five- port holes with the same internal incisions as open surgery. TIF, on the other hand, is considered "minutely invasive" requiring no incisions.

"The TIF procedure recreates the anti-reflux barrier between the esophagus and stomach and is performed trans-orally (through the mouth)," said Benjamin Havemann, MD, gastroenterologist at Scott & White -- Round Rock. "The procedure can reduce a small hiatal hernia and creates a valve between the stomach and esophagus restoring the natural, physiological anatomy to prevent reflux. Because the procedure is incisionless, there is reduced pain, shorter recovery time required, and no visible scar."

Recent studies show that TIF can reduce patients' dependency on medications with 80 percent of patients remaining off their daily medications after two years and experiencing an improvement in their quality of life. After the TIF procedure, clinical trials show that many patients can eat and drink foods they avoided for years.

Dr. Havemann, director of the division of gastroenterology, routinely performs a variety of advanced endoscopic procedures.

Dr. Buckley, director of general surgery, was the first surgeon in the Central Texas region to perform a Single-Incision Laparoscopic (SILS) Nissen Fundoplication, a technique performed with a single incision in the belly button to treat esophageal reflux (GERD).