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Transoral incisionless fundoplication

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This is an old revision of this page, as edited by Kvng (talk | contribs) at 14:11, 27 June 2017 (cleanup). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.


  • Comment: Thanks for your comment. I was under the assumption that medical geared Wikipedia articles could use high quality primary sources. I spent a good bit of time studying other medical articles on wikipedia (like the Stretta procedure article) and many of them tend to use primary resources because that's often the most accurate and high quality information that can be found that doesn't use commercial sites. We can take this to a talk Seraphim System (if you want) I'm genuinely curious where the line is. SalSol (talk) 20:20, 23 May 2017 (UTC)

Transoral incisionless fundoplication, also known as TIF procedure, is an endoscope treatment designed to relieve symptoms of gastroesophageal reflux disease (GERD). The TIF procedure, similar to Nissen fundoplication, alleviates GERD symptoms by wrapping a portion of the stomach around the esophagus.[1]

The TIF procedure, unlike laparoscopic fundoplication, does not require surgical incisions. Instead a surgical device (called the EsophyX) is inserted into the mouth, passed through the throat, and into the stomach. An endoscope is utilized to perform the procedure in order to avoid the need for incisions.[2]

A minority of individuals who undergo the TIF procedure also require a hiatal hernia repair operation.[3]

The procedure is performed while the patient is under general anesthesia[4] and is typically an outpatient procedure.[1]

Other medical and endoscopic treatments to alleviate GERD symptoms include:

The TIF procedure isn't the ideal GERD solution for all patients. Dr. Kamran Ayub, board certified gastroenterologist, explained to the Chicago Tribune, that the procedure is best suited to GERD patients that have moderate to severe GERD symptoms, do not wish to take PPIs, or experience negative affects from antireflux medication.[8]

History

The device utilized to perform the procedure, called EsophyX, was developed by EndoGastric Solutions. The first TIF procedure utilizing the device was performed in 2005.[9] The device received European Union CE mark in 2006 and United States Food and Drug Administration issued initial 510(k) clearance in 2007.[10][2]

In February of 2015, the American Medical Association's CPT Editorial Panel reviewed whether to create a new category 1 current procedural terminology (CPT) code for the TIF procedure. In January of 2016, a unique code for the transoral incisionless fundoplication procedure was created and implemented.[11]

As of 2016, more than 17,000 TIF procedures had been performed.[9]

In July 2016, Health Care Service Corporation (HCSC) became the first United States health insurance company to add the TIF procedure to their medical coverage policy. HSCS added the TIF procedure to their health insurance policy at the recommendation of both the American Gastroenterological Association (AGA) and The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).[12]

Evidence

In 2012, the TIF EsophyX vs Medical PPI Open Label (TEMPO) randomized control trial was conducted to compare the efficiency of the TIF procedure to PPI therapy in the treatment of GERD symptoms. At the six month follow up, 62% of the TIF patients and 5% of the PPI patients experienced the elimination of all GERD (other than heartburn) symptoms. Despite the results of the study, the need for followup studies was suggested.[13]

In 2014, a double blind study was published. This randomized controlled trial was conducted to determine the TIF procedure's ability to eliminate GERD symptoms. Patients were randomly split into two groups. One group received the TIF procedure and a placebo. The other half a sham surgery and omeprazole. After six months, 67% reported the elimination of troublesome regurgitation (a GERD symptom) versus 45% in the sham group. The study also found that TIF provided better control of heartburn after six months. Medium heartburn scores of TIF patients decreased from 2.6 to 0.5.[14]

In 2014, a study from Italy assessed long-term affects of the TIF procedure on patients with GERD symptoms. Fifty patients were followed up with up to six years after the procedure was conducted. The study found that after three years around 75-80% of the patients ceased to need or halved the amount of PPI therapy due to decreased GERD symptoms. Testoni, et al reported lasting elimination of daily dependence on PPI in 75-80 % of patients for up to 6 years.[15]

References

  1. ^ a b "Is It GERD? Recognizing Atypical Symptoms | Physician's Weekly for Medical News, Journals & Articles". www.physiciansweekly.com. Retrieved 2017-05-18.
  2. ^ a b "GERD Device Maker Uses Clinical Data to Prove Its Point | MDDI Medical Device and Diagnostic Industry News Products and Suppliers". www.mddionline.com. Retrieved 2017-05-18.
  3. ^ Kennedy, Sam. "New Easton Hospital procedure fixes heartburn". themorningcall.com. Retrieved 2017-06-06.
  4. ^ "MCW: Endoscopic Transoral Incisionless Fundoplication". www.mcw.edu. Retrieved 2017-05-18.
  5. ^ Hopkins, Jessica; Switzer, Noah J.; Karmali, Shahzeer (2015-08-25). "Update on novel endoscopic therapies to treat gastroesophageal reflux disease: A review". World Journal of Gastrointestinal Endoscopy. 7 (11): 1039–1044. doi:10.4253/wjge.v7.i11.1039. PMC 4549661. PMID 26322157.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  6. ^ Housenick, Mandy. "Region's smaller hospitals focus on specialties". Lehigh Valley Business Cycle. Retrieved 2017-06-06.
  7. ^ Trad, Karim S.; Barnes, William E.; Simoni, Gilbert; Shughoury, Ahmad B.; Mavrelis, Peter G.; Raza, Mamoon; Heise, Jeffrey A.; Turgeon, Daniel G.; Fox, Mark A. (2017-05-15). "Transoral Incisionless Fundoplication Effective in Eliminating GERD Symptoms in Partial Responders to Proton Pump Inhibitor Therapy at 6 Months". Surgical Innovation. 22 (1): 26–40. doi:10.1177/1553350614526788. ISSN 1553-3506. PMC 4361451. PMID 24756976.{{cite journal}}: CS1 maint: PMC format (link)
  8. ^ Community Contributor tsimons (2017-06-02). "From the community: New Device to Treat Acid Reflux Leaves No Scars". Chicago Tribune. {{cite web}}: |last= has generic name (help); Cite has empty unknown parameter: |dead-url= (help)
  9. ^ a b Sami Trad, Karim (2017-05-10). "Transoral incisionless fundoplication: current status". Current Opinion in Gastroenterology. 32 (4): 338–343. doi:10.1097/MOG.0000000000000275. ISSN 0267-1379. PMC 4894777. PMID 27023164.{{cite journal}}: CS1 maint: PMC format (link)
  10. ^ "Incision-free surgery treats acid reflux: Allegan surgeon is training other doctors to do the procedure". MLive.com. Retrieved 2017-05-10.
  11. ^ "AMA creates CPT code for transoral incisionless fundoplication procedure for GERD". www.healio.com. Retrieved 2017-06-06.
  12. ^ "TIF procedure for reflux now covered by Blue Cross Blue Shield of Texas". Plainview Daily Herald. Retrieved 2017-05-10.
  13. ^ Trad, Karim S.; Barnes, William E.; Simoni, Gilbert; Shughoury, Ahmad B.; Mavrelis, Peter G.; Raza, Mamoon; Heise, Jeffrey A.; Turgeon, Daniel G.; Fox, Mark A. (2017-05-11). "Transoral Incisionless Fundoplication Effective in Eliminating GERD Symptoms in Partial Responders to Proton Pump Inhibitor Therapy at 6 Months". Surgical Innovation. 22 (1): 26–40. doi:10.1177/1553350614526788. ISSN 1553-3506. PMC 4361451. PMID 24756976.{{cite journal}}: CS1 maint: PMC format (link)
  14. ^ Hunter, John G.; Kahrilas, Peter J.; Bell, Reginald C. W.; Wilson, Erik B.; Trad, Karim S.; Dolan, James P.; Perry, Kyle A.; Oelschlager, Brant K.; Soper, Nathaniel J. (2015-02-01). "Efficacy of transoral fundoplication vs omeprazole for treatment of regurgitation in a randomized controlled trial". Gastroenterology. 148 (2): 324–333.e5. doi:10.1053/j.gastro.2014.10.009. ISSN 1528-0012. PMID 25448925.
  15. ^ Testoni, Pier Alberto; Testoni, Sabrina; Mazzoleni, Giorgia; Vailati, Cristian; Passaretti, Sandro (2015-09-01). "Long-term efficacy of transoral incisionless fundoplication with Esophyx (Tif 2.0) and factors affecting outcomes in GERD patients followed for up to 6 years: a prospective single-center study". Surgical Endoscopy. 29 (9): 2770–2780. doi:10.1007/s00464-014-4008-6. ISSN 1432-2218. PMID 25480624.

Category:Digestive system procedures Category:Endoscopy

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