Video Tip: Transoral Incisionless Fundoplication | December 2021-Transoral Incisionless Fundoplication

Video Transcription

Let's turn to transoral incisionless fundoplication, or TIF, where a series of H-shaped fasteners  are applied for a full thickness plication to recreate the gastroesophageal flap valve from the inside out instead of the outside in, as our surgical colleagues would do.  We get about a two to three centimeter long valve of approximately 270 degrees, so somewhat akin to a toupee fundoplication, though there are some folks who are now finding ways to  get that number of degrees involved well over 300 with some special maneuvers. You cannot have a hiatal hernia of two centimeters or greater before the TIF.  There are some data that are out there now about using a TIF in combination with a hiatal  hernia repair to be done either concurrently or in a staged procedure with the hiatal hernia  repair first, but we know that a large, clinically significant hiatal hernia decreases the likelihood of longevity.

Video Summary

The video discusses transoral incisionless fundoplication (TIF), a technique used to recreate the gastroesophageal flap valve from the inside out. This involves applying a series of H-shaped fasteners to create a two to three centimeter long valve of approximately 270 degrees, similar to a toupee fundoplication. Some surgeons have found ways to increase the number of degrees to over 300 with special maneuvers. However, a hiatal hernia of two centimeters or greater should not be present before undergoing TIF. There is some data on using TIF in combination with hiatal hernia repair, either concurrently or in a staged procedure, but large hiatal hernias decrease longevity chances.

Keywords

transoral incisionless fundoplication

gastroesophageal flap valve

H-shaped fasteners

toupee fundoplication

hiatal hernia repair