Incisionless Surgery at MemorialCare Saddleback Medical Center Treats Gastroesophageal Reflux Disease (GERD)


Over 20 million Americans suffer from daily heartburn and other chronic symptoms of reflux disease like regurgitation, chronic cough, and hoarseness. They face a lifetime of daily medications and often incomplete resolution of their symptoms or risks of invasive surgery.

An alternative is now available for patients suffering from gastroesophageal reflux disease (GERD), thanks to an incisionless procedure called TIF (Transoral Incisionless Fundoplication) performed at MemorialCare Saddleback Medical Center.

The TIF procedure is based on the same principles of surgical repair of the anti-reflux barrier, except it is “surgery from within,” performed using an endoscope—the same equipment used to diagnose GERD.

The procedure is performed through the mouth without incisions. The physician utilizes a special device to reconstruct the valve between the esophagus and stomach to restore the body’s natural protection against reflux. Because it is incisionless, there is less pain, shorter recovery, and no visible scar.

“The TIF procedure can provide significant relief of GERD symptoms for our patients.” says Ketan Shah, M.D., a Saddleback Medical Center gastroenterologist who performs the procedure.

“Reflux medications like PPIs—proton pump inhibitors—can help relieve patients' heartburn symptoms but don't address the underlying anatomical problem or prevent further disease progression,” says Dr. Shah. “Even on PPIs, many patients still need to restrict what they eat or drink and are forced to sleep upright to reduce nighttime reflux. There are also increasing concerns about the safety of long-term use of PPIs.”

Recent studies demonstrated the TIF procedure can reduce patients’ dependency on reflux medications. After three years, over 70% of patients were still completely off their daily reflux medications and experienced a dramatic improvement in their quality of life.

“Traditional anti-reflux surgery can be effective but is invasive and can be associated with risks and long-term side effects,” adds Dr. Shah. “The TIF procedure has similar efficacy but with significantly lower risks and side effects. After the TIF procedure, clinical trials show most patients can eat and drink foods they avoided for years, and reflux no longer impacts their life as it previously did.”