Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Gastroenterology - January 2019

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/1070678

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Page 15 of 58

Next, I present all the information I've collected to one of our spe- cialists. Our goal is to do everything as a one-stop shop, so a couple of days later, when we schedule a consultation, we can also have any needed testing done at the same time. That way, people don't have to take a lot of time off from work. They can get everything done and follow-up with a physician a couple of days later after their individual- ized plan is in place. Time for incision-free TIF For patients who have chronic reflux and who don't respond to lifestyle changes or medication, we've had tremendous success, pri- marily with the endoscopic TIF (transoral incisionless fundoplica- tion) procedure. Similar to Nissen fundoplication, TIF alleviates GERD symptoms by wrapping a portion of the stomach around the esophagus to restore the esophageal valve. But unlike traditional fun- doplication, the TIF procedure is performed through the mouth rather than through laparoscopy or open abdominal incisions. We did our first few TIFs in 2016, then almost 40 in 2017 and well over 50 in 2018. Among the anti-reflux procedures we do, TIF offers immediate results. We usually do it as an outpatient procedure, and many of our patients are off their medications within 2 or 3 months. They can enjoy the foods they couldn't eat previously, without any ill effects — even such trigger foods as chili, wine, chocolate and coffee. To help document our success, I give patients a quality-of-life survey the day of the procedure and the same survey again after 2 months. The questions cover severity of symptoms, whether their reflux keeps them up at night, how often they have regurgitation and so forth. What we find is that on a 0 to 50 scale, with zero being the score that indicates no problems at all, the average before surgery is around 25; 1 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 9

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