Transoral incisionless fundoplication (TIF®) is a minimally invasive procedure used to treat chronic heartburn and gastroesophageal reflux disease (GERD). This advanced endoscopic procedure recreates and restores the natural function of the anti-reflux valve between the esophagus and stomach. This valve aids in the protection against acid reflux or stomach acid creeping up into the esophagus.

During the procedure, an endoscopic device is inserted orally and fed through the esophagus into the stomach. The physician uses the device to reconstruct the anti-reflux valve. This involves wrapping the upper portion of the stomach (fundus) around the damaged lower portion of the esophagus and securing it with polypropylene fasteners (fundoplication). These fasteners are left in place to secure the newly constructed valve while the tissue heals. There’s no need to remove them as the body heals around them.


TIF® is a good solution for adults with moderate-to-severe GERD who experience heartburn symptoms even while on daily medications. You may not need this procedure if your symptoms are controlled by making lifestyle changes or following instructed use of proton pump inhibitors (PPIs).

There are many benefits to this procedure, including controlling disruptive symptoms and getting off daily heartburn medicine. The TIF® procedure is cleared by the FDA and is covered by most insurance companies. Since it is an endoscopic procedure and minimally invasive, it leaves no incisions. This means that there are no metal implants and no gas or bloating following.

Since your physician will be working in your esophagus and stomach, it is important not to eat or drink anything for several hours before the exam. Your physician will give you instructions about the use of regular medications, including blood thinners, before the exam. Because of the mild sedation, you are not allowed to drive, operate heavy machinery or make any important decisions immediately following the exam. It’s important to have someone with you to drive you home.

The TIF® procedure takes about 30 minutes.

Most patients can return home the same or following day and resume most ordinary activities within a few days. Patients should expect to experience some minor discomfort following the procedure – sore throat, hoarseness, nausea, difficulty swallowing – but these are all temporary.

Your physician will recommend following a modified diet for several weeks post-procedure. This modified diet will contain phases of graduating texture – clear liquids, full liquids, soft food – introducing each new texture on a schedule. It’s important to follow this diet closely to ensure the new valve heals properly.

The TIF® procedure is extremely safe, and there have been no reports of major complications.

Many clinical studies have shown that when patients adhere to the recommended post-procedure diet the TIF® procedure is considered to be a long-lasting treatment for chronic acid reflux.