Therapeutics) is
indicated for
patients who
have hiatal her-
nias smaller
than 2 cm, and
unlike the oth-
ers, it's done
under con-
scious sedation.
A specialized
catheter that you insert through the mouth, into the esophagus, delivers
low levels of non-ablative radiofrequency energy to the lower esophageal
sphincter and top of the stomach to strengthen the muscle between the
stomach and esophagus.
It's time-tested (studies go back 10 years or more) and has been
proven to reduce esophageal acid exposure and the need for proton
pump inhibitors (PPIs), and improve health-related quality of life.
Patients are usually able to go home within a few hours and resume
normal activities the next day. Typically they're weaned off their PPIs
within about 8 weeks and see significant improvement within 3
months. Many Medicare and private insurers cover the procedure.
Transoral incisionless
fundoplication (TIF)
TIF is a modification of the traditional surgical fundoplication proce-
dure in which the upper portion of the stomach is wrapped around
the lower part of the esophagus to reconstruct the anti-reflux barrier.
Nissen fundoplication surgeries go back more than 50 years. But with
TIF (marketed by EndoGastric Solutions), there's no incision. You
2
8 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 6
• FORCE OF NATURE Several years of follow-up studies suggest that patients respond well to the LINX
procedure, in which you place a ring of magnetic titanium beads around the lower part of the esophagus.
