A device the size of a toy fishing pole makes it possible to perform less invasive surgery on reflux patients. The procedure—transoral incisionless fundoplication (TIF)—may be an alternative to a more common laparoscopic operation for some sufferers of gastroesophageal reflux disease (GERD).
Explore this issue:November 2012
While the TIF repair is typically undertaken by general surgeons, otolaryngologists are often involved in the care of patients whose reflux problems extend beyond the esophagus and into the upper airway, causing atypical GERD symptoms such as chronic cough, hoarseness, laryngeal nodules, swallowing difficulties, throat pain and persistent sinus infections.
“I’ve been referring patients for the [TIF] procedure for about four years. It’s a great option for those with laryngopharyngeal reflux [LGR],” said Ed Hepworth, MD, an otolaryngologist and director of the Colorado Sinus Institute in Denver. These patients don’t present with the typical esophageal manifestations of GERD, but they may instead experience frequent infections, nasal polyps and sinonasal problems without other explanation. TIF also works well to combat persistent hoarseness and frequent throat clearing in properly selected patients. Several of Dr. Hepworth’s patients who underwent TIF have been relieved of their chronic cough, and some patients have been able to avoid antibiotics and sinus surgery.