Anti-reflux procedures


TIF stands for “Transoral Incisionless Fundoplication” and is performed with the EsophyX device. EsophyX TIF is a minimally invasive procedure and offers a new advancement in the treatment of chronic acid reflux and GERD by reconstructing the body’s own anti-reflux barrier.

The EsophyX device and an endoscope are introduced together through the patient’s mouth (transorally) and advanced into the esophagus. With an endoscope, the doctor uses the EsophyX device to reconstruct the anti-reflux valve by wrapping the stomach’s fundus around the distal esophagus and securing it with poly-propylene fasteners.

The EsophyX TIF procedure generally takes about 30-45 minutes, and most patients can go home the next day and return to work and most normal activities within a few days.


Concomitant Laparoscopic Hiatal Hernia Repair + TIF (c-TIF)

Some patients do not qualify for an endoscopic TIF procedure because they have a hiatal hernia greater than 2 cm in size, or a gastroesophageal junction that is too loose. A hiatal hernia of this size results in changes to the esophagus and stomach, resulting in reflux.  For these patients we offer a combination laparoscopic and endoscopic approach to achieve GERD relief. The combination procedure is known as a concomitant TIF procedure or a c-TIF.

During c-TIF, the surgeon laparoscopically repairs the greater than 2 cm hiatal hernia by pulling the stomach and the bottom of the esophagus back into the abdominal cavity. The diaphragmatic defect is then repaired with the use of sutures that re-tighten the diaphragm around the distal esophagus, thus narrowing the opening of the hiatus. Immediately following this part of the procedure, we perform an endoscopic TIF procedure to re-create and strengthen a valve structure that serves as a barrier to acid reflux.

In the majority of cases, insurance covers the cost of a concomitant TIF procedure (c-TIF).


To learn more about TIF and c-TIF, visit our website San Francisco Center for Acid Reflux and GERD.