Benefits of Concomitant Laparoscopic Hiatal Hernia Repair + endoscopic TIF (c-TIF)
The c-TIF procedure is a minimally invasive approach to achieving GERD relief in patients who do not qualify for endoscopic therapy alone. The majority of patients seeking anti-reflux intervention have anatomy not amenable to TIF alone. While c-TIF includes a laparoscopic surgical component, it is a combination laparoscopic and endoscopic procedure designed to surgically reduce large hiatal hernias and repair associated diaphragmatic defects while endoscopically creating a new gastroesophageal valve structure that serves as a barrier to acid reflux.
Critically, though surgery is necessary as part of this procedure, the long-term side effects of traditional anti-reflux surgery are still avoided. Namely, endoscopic TIF rather than surgical Nissen fundoplication following hernia repair limits the risk of long-term difficulty swallowing, gas-bloat syndrome, inability to burp or vomit, or increased flatulence.
During the procedure itself, the surgical component of c-TIF is also technically less complicated compared to full surgical anti-reflux intervention. By just performing hernia reduction and diaphragm repair while avoiding surgical fundoplication, the surgeon no longer needs to dissect along the fundus of the stomach in order to make a surgical wrap. Surgically cutting through this location may be complicated by bleeding since this involves taking down blood vessels called the short gastric vessels.