How is endoscopic surgery for GERD perfomed?

Dr. Michael B. Ujiki, MD
Bariatric Medicine (Obesity Medicine) Specialist

The scarless procedure used to treat gastroesophageal reflux disease (GERD) is called a transoral incisionless fundoplication (TIF). There is no incision, no scar and no pain associated with that incision. With the use of a standard endoscope, a long, flexible tube with a camera on its end, we enter through the mouth and down the esophagus, where the valve at the end of the esophagus  is rebuilt and restored to its natural anatomy. This results in a barrier to stomach acid. Candidates for this procedure include those who have proven reflux and are not responsive to medications or do not want to be on medications long term. The new TIF procedure resolves heartburn in over 90 percent of patients. It also results in complete cure of reflux in 70 percent to 80 percent of patients being off antacids.

Endoscopy for gastroesophageal reflux disease (GERD) has been an option for treatment, but at this time it is deemed as experimental. It entails special instruments being put through or on an endoscope, which is then inserted into the esophagus down into the stomach to treat the GERD. Unfortunately, most of the techniques that have been developed have resulted in inadequate results, but it is a constant area of research, with new techniques being developed. Talk to a physician for more information.

When a patient experiences common symptoms of gastroesophageal reflux disease (GERD), namely heartburn and/or acid regurgitation, additional tests prior to starting treatment are typically unnecessary. If symptoms do not respond to treatment, or if other symptoms such as weight loss, trouble swallowing or internal bleeding are present, additional testing may be necessary. Upper endoscopy is a test in which a small tube with a light at the end is used to examine the esophagus, stomach and duodenum (the first portion of the small intestine). Before this test, you will receive medications to help you relax and lessen any discomfort you may feel. An upper endoscopy allows your doctor to see the lining of the esophagus and detect any evidence of damage due to GERD. A biopsy of tissue may be done using an instrument similar to tweezers. Obtaining a biopsy does not cause pain or discomfort. Another test, known as pH testing, measures acid in the esophagus and can be done by either attaching a small sensor into the esophagus at the time of endoscopy or by placing a thin, flexible probe into the esophagus that will stay there for 24 hours while acid content is being measured. This information is transmitted to a small recorder that you wear on your belt. X-ray testing has no role in the initial evaluation of individuals with symptoms of reflux disease.

The surgeon performs endoscopic repair of GERD entirely through the mouth without making any external or internal incisions. Instruments and a small camera are inserted through the mouth and advanced to the junction between the esophagus and the stomach, where the stomach is tacked alongside the esophagus in order to create a more effective barrier to reflux.

Dr. Manuel E. Rodriguez, MD

Endoscopic testing is used to determine the risk of esophageal cancer in patients with GERD. Watch this video with Manuel Rodriguez, MD from Blake Medical Center to learn how.

Endoscopic testing for GERD is performed for patients who’ve had persistent heart burn, indigestion, burping and belching. Watch James R. Curtiss, MD, of Spotsylvania Regional Medical Center, explain how this test looks for tissue damage.

Patients with gastroesophageal reflux disease (GERD) can get relief with endoscopic surgery. In this video, John Bagnato, MD, of Coliseum Medical Centers, explains the Hill procedure for hiatal hernia.

Continue Learning about GERD



GERD -- gastroesophageal reflux disease -- can cause heartburn, however, it isn’t the same. GERD is a chronic problem that is experienced at least twice a week. Learn more from our experts about GERD.

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.