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Esophyx Incisionless Surgery

Esophyx Incisionless Surgery

EsophyX TIF (transoral incisionless fundoplication) is the latest treatment for safely and effectively treating chronic acid reflux disease, also known as gastroesophageal reflux disease (GERD). A completely incisionless procedure, EsophyX TIF reconstructs the antireflux barrier to provide a solution to the anatomical root cause of GERD. The procedure is for patients who are dissatisfied with current pharmaceutical therapies or are concerned about the long-term effects of daily use of reflux medications.

TIF is performed endoscopically using the innovative EsophyX surgical device from EndoGastric Solutions. In clinical studies, 79% of patients remained off daily PPIs (proton pump inhibitors) and 70% experienced a total elimination of heartburn at two years after the EsophyX TIF procedure.

What is GERD?

If you have heartburn twice a week or more, you may have GERD. Heartburn is the most common symptom, but you may also experience:

  • Hoarseness or sore throat
  • Frequent swallowing
  • Asthma or asthma-like symptoms
  • Pain or discomfort in the chest
  • Sleep disruption (unable to sleep lying down)
  • Bloating
  • Excessive clearing of the throat
  • Persistent cough
  • Burning in the mouth or throat
  • Intolerance of certain foods
  • Dental erosions or therapy-resistant gum disease or inflammation

Normally, after swallowing, a valve between the esophagus and stomach opens to allow food to pass, then it closes to prevent stomach contents from “refluxing” back into the esophagus, causing a burning sensation in the chest. For people who suffer from GERD, the valve is dysfunctional and unable to prevent acid from refluxing into the esophagus.

Why pharmaceuticals are not a long-term solution

GERD today is typically treated with medications such as histamine receptor antagonists (H2 blockers), such as Pepcid, Tagamet and Zantac, and proton pump inhibitors (PPIs), such as Nexium, Prilosec and Protonix. These medications can lose their effectiveness over time. They also don’t treat the underlying root causes of reflux, the deteriorated anatomy of the antireflux barrier, so life-long medication therapy is required. In addition, recent studies on the adverse effects of long-term use of PPIs indicate a significantly higher incidence of hip fractures, particularly among women.

Conventional surgical treatment

For people who have severe GERD, surgical intervention may be required. Though the conventional laparoscopic procedure has long been proven a very effective long-term solution, it is still “invasive.” It includes incisions and patients must remain in the hospital for up to several days. For that reason, the number of GERD sufferers who undergo the procedure is relatively small.

EsophyX TIF Procedure

EsophyX TIF was developed to emulate more invasive surgical techniques, but from within and completely without incisions and visible scars. The FDA cleared EsophyX device is completely incisionless and is performed through the mouth, rather than through an abdominal incision. Typically lasting no more than 30-45 minutes, the procedure is performed under general anesthesia and reconstructs the antireflux barrier to restore the competency of the gastroesophageal junction. Most patients can go home the next day and return to work within a few days.

Step 1: The specially designed EsophyX device enters the esophagus through the mouth and is positioned at the junction of the stomach and esophagus. EX-step1
Step 2: The EsophyX device pulls and fastens a tissue fold. EX-step2
Step 3: Step 2 is repeated multiple times to reconstruct a robust, tight valve that prevents the reflux of stomach contents up into the esophagu, resulting in the effective elimination of GERD. EX-step3

Frequently Asked Questions:

What is gastroesophageal reflux disease (GERD)?
It is the flow of the stomach’s contents and acid back up into the esophagus. This happens when the esophageal valve, part of the antireflux barrier becomes weak or nonfunctional. GERD is also called heartburn, reflux and esophageal reflux.

What are the consequences of GERD?
Over the long term, persistent exposure of the delicate tissue of the esophagus to the acid contents of the stomach can cause chronic inflammation or esophagitis which can lead to a potentially serious condition called Barret’s Esophagus.

In some cases GERD suffers may experience non-heartburn symptoms. Symptoms may include hoarseness, persistent cough, dental erosions, sore throat, discomfort in the ears and nose and asthma-like symptoms. These symptoms can not typically be resolved through drug therapy.

How is GERD treated?
In addition to dietary controls, medications like non-prescription antacids, PPIs (proton pump inhibitors) and H2 blockers help prevent the acceleration of GERD. Over time however, these medications may lose their effectiveness requiring increased dosage, increasing cost and the increasing the risk of long term side effects. Invasive surgical procedures such as the Nissen Fundoplication have long been known to be effective therapy for GERD. The risk of adverse events and the invasive nature of these procedures has made them lose popularity in recent years. The TIF procedure offers a minutely invasive surgical solution for the treatment of GERD, a clinically proven procedure without incisions.

What is EsophyX TIF?
EsophyX TIF is a surgical procedure performed through the mouth which reconstructs the barrier between the stomach and esophagus to prevent stomach fluids from refluxing up into esophagus. EsophyX TIF is completely incisionless so it has less risk, reduced recovery time and no visible scar.

What can the patient expect from EsophyX TIF?
The EsophyX TIF procedure is performed safely, quickly, comfortably, with no incisions and with minimal downtime. While under anesthesia the flexible EsophyX device will be gently lowered through the mouth into the stomach under the visualization of an endoscope “video” placed down the shaft of the device. Once inside the stomach, the surgeon will manipulate the device to create a tight sealing valve and hold it in place with suture-like fasteners.

What can the patient expect after treatment?
Most patients can return to work the next day or within a few days following their EsophyX TIF procedure. Patients will likely experience some manageable discomfort in their chest, nose, throat and stomach for the first few days to a week. Patients will be asked to restrict physical activity for the first week and will be given dietary guidelines to help maximize their success while their new antireflux valve heals.

Is EsophyX TIF safe?
EsophyX TIF has been proven safe in use in hundreds of procedures worldwide. The EsophyX TIF procedure is expected to be safer than traditional surgery which often involves incisions in the skin for access to the organs, and cutting around the organs to free the desired area for suturing. With EsophyX TIF, there are no incisions inside on the organs or outside on the skin.

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Want to learn more about EsophyX and how it could help you? Contact us today!

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