Transoral incisionless fundoplication

Dr. KumtaNikhil A. Kumta, MD from the Division of Gastroenterology and Hepatology at Weill Cornell Medical College in New York, New York, USA presents this video case, “Transoral incisionless fundoplication for treatment of refractory GERD after peroral endoscopic myotomy.”

Medical management of gastroesophageal reflux disease with proton pump inhibitors is effective in 70-80% of patients. For refractory reflux patients, transoral incisionless fundoplication (TIF) is an anti-reflux endoscopic procedure that uses an endoluminal device to rebuild the gastroesophageal valve. In this video, we present a patient with medically refractory reflux following a peroral endoscopic myotomy for treatment of achalasia. Via use of the fundoplication device, polypropylene fasteners were deployed to successfully create a fundoplication wrap 270 degrees in circumference at the esophagogastric junction. Following the procedure, the patient’s reflux symptoms resolved and proton pump inhibitor therapy was later discontinued.

TIF is a minimally invasive endoscopic procedure for treatment of medically refractory gastroesophageal reflux disease with 70-80% of patients achieving symptomatic improvement and medication cessation.

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