TIF Procedure

The TIF® procedure (Transoral Incisionless Fundoplication) fixes the root cause of reflux.

TIF trained physicians are able to restore the natural shape, location and effectiveness of your esophageal valve with an innovative procedure, stopping reflux.

The vast majority of patients experience little discomfort post-procedure. After the healing period of four to six weeks, they are off daily PPIs and back to their healthy state once more.


  • Minimally invasive
  • Fast recovery
  • No incisions
  • FDA cleared
  • No increased flatulence
  • Exemplary safety profile
  • No increased bloating
  • Covered by most insurance
  • No metal implant
  • Controls disruptive symptoms

What is the TIF Procedure for Reflux?

The minimally-invasive TIF 2.0 procedure (TIF stands for Transoral Incisionless Fundoplication) is designed to reposition and reconstruct a durable anti-reflux valve while also tightening the Lower Esophageal Sphincter (LES) to restore the body’s natural protection against reflux. It is performed endoscopically through the mouth, meaning there are no incisions necessary.

Abdominal incisions are not required unless additional treatments are being performed with the TIF procedure, such as a hiatal hernia repair (HHR). For patients presenting with both GERD and a hiatal hernia measuring >2cm, a laparoscopic or robotic hiatal hernia repair may be performed immediately prior to the endoscopic TIF procedure. The HHR plus TIF procedure can be performed in the same anesthesia setting should patient anatomy dictate repair of both a hernia and the antireflux valve.

TIF patients often experience a faster recovery since there is no internal cutting, and clinical studies demonstrate they rarely experience long-term side effects commonly associated with traditional antireflux surgery such as trouble swallowing (dysphagia), gas bloat syndrome and increased flatulence.

To date, the TIF 2.0 procedure has been performed in more than 27,000 patients worldwide. Due to the unique approach of the TIF 2.0 procedure, most patients return to work and normal activities within a few days after the procedure, allowing them to get back to life sooner, free of the distraction and discomfort of GERD.

While the TIF 2.0 procedure has an excellent safety profile and is less invasive than traditional laparoscopic fundoplication, it is important to note that it is still a surgical approach. There are potential risks and complications with any surgery, including those with an endoscopic approach, which can include but are not limited to sore throat, musculoskeletal pain, epigastric or abdominal pain and difficulty swallowing.

The TIF Patient Journey

The path to a reflux-free life begins when you decide that managing your symptoms is not solving the problem. Typically, people will attempt to first control the symptoms with diet and lifestyle changes. When that ceases to have an affect on symptoms, your doctor will suggest PPIs.

Since you can’t cure reflux with either of those steps, people often choose to have their valve restored to its original effectiveness with the TIF procedure.

Before your TIF Procedure

Your physician will fully prepare you for your procedure day and beyond during your consultation. A little planning goes a long way, so do arrange for transportation home after the procedure and have meals ready to go that adhere to the diet provided by your physician.

Given that your physician will be working in your esophagus and stomach, you will need to be sure your stomach is empty of food and medicines by fasting for several hours before your procedure.

During your TIF Procedure

While you are under anesthesia, your physician will access the stomach through your mouth using a flexible, camera-equipped, single use device. The device enables your physician to gently pull the esophagus down and wrap the top of the stomach partially around the esophagus, all without a single incision.Plastic fasteners are used to hold the tissue in place. Your body will heal around these fasteners. If you have a small hiatal hernia, this will also be fixed as part of the procedure.

After your TIF Procedure

Every person is unique, and TIF trained physicians understand this, so expect your doctor to give you specific instructions about post-procedure care based on your personal situation. You can count on needing to follow a diet that gradually moves from liquids to solids while your restored valve heals. This can take four to six weeks, depending on each individual.

Just remember during this time that you are in the homestretch!

As long as your job doesn’t involve a lot of physical exertion, you may return to work a few days after the procedure. It’s important that you not lift heavy items or do any strenuous physical exercise until your physician sees you for a post follow-up exam.

Because the procedure is gentler on the body than other traditional laparoscopic procedures, there is less discomfort, but you may experience some minor soreness in your throat, chest, and shoulder area, which will dissipate over a few days.