Nineteen million Americans suffer with daily heartburn or other symptoms of reflux such as regurgitation, chronic cough, hoarseness and dental erosions. Until recently these people faced either a lifetime of daily medications and often incomplete resolution of their symptoms, or the risks of invasive surgery. Now they have a better option. The new Transoral Incisionless Fundoplication procedure, or TIF, using the innovative EsophyX device is performed completely without incisions and is now available from Dr. Jatinder Pruthi and Dr. Emery Chen (contributing hiatal hernia repair) at Palmdale Regional Medical Center.
Dr. Pruthi is the first specialist at Palmdale Regional Medical Center to perform the TIF procedure. “The TIF procedure can significantly improve quality of life for our patients,” said Dr. Pruthi. “Gastroesophageal Reflux Disease (GERD) is an anatomical problem which needs an anatomical solution. Reflux medications like proton pump inhibitors (PPIs) can help relieve patients' heartburn symptoms, but don't solve the underlying anatomical problems or prevent further disease progression. Even on PPIs many patients are still unable to eat the foods they want or have to sleep sitting up to reduce nighttime reflux. In addition, recent studies have shown that long term use of PPIs can lead to bone fractures, malabsorption of nutrients, kidney disease, stroke and dementia. After the TIF procedure, clinical trials show that most patients can eat and drink foods they avoided for many years. Reflux no longer impacts their life like it previously did.”
The TIF procedure is based on established principles of surgical repair of the anti-reflux barrier, except that it is “surgery from within” performed transorally. The procedure reduces 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, reduced recovery and no visible scar. “Being the physician that performs the hiatal hernia repair in patients requiring it, we are very excited to be able to offer our patients the same incredible benefits without incisions as more invasive procedures require," said Dr. Emery Chen.
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The TIF procedure represents the revolutionary next step in the evolution of surgery. Laparoscopy, a form of “minimally invasive surgery,” typically requires three-to-five port holes and the same internal incisions and organ dissection as open surgery. TIF requires neither abdominal incisions or internal dissection, making it a truly “minimally invasive” surgical procedure to effectively treat GERD. With millions of Americans suffering with daily symptoms of reflux and many not fully satisfied with their current medical therapy, TIF offers an excellent alternative.
The EsophyX device with SerosaFuse® fasteners is indicated for use in transoral tissue approximation, full thickness plication and ligation in the gastrointestinal tract and is indicated for the treatment of symptomatic chronic GERD in patients who require and respond to pharmacological therapy. It is also indicated to narrow the gastroesophageal junction and reduce hiatal hernia ≤ 2 cm in size in patients with symptomatic chronic GERD.
Patients with hiatal hernias larger than 2 cm may be included, when a laparoscopic robotic assisted hiatal hernia repair reduces the hernia to 2 cm or less.
About the TIF EsophyX Procedure
Widely recognized as the next step in the evolution of minimally invasive techniques, the EsophyX device is introduced into the body, not through an incision, but through a “natural” body orifice, the mouth. The EsophyX device and the TIF procedure reduce hiatal hernia and create a valve between the stomach and the esophagus to restore the natural, physiological anatomy to reduce/prevent gastroesophageal reflux. Because the procedure is incisionless, there are no visible scars and the risk of adverse effects is reduced.
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