Reflux Surgery


Reflux Surgery

surgeryIf you’re suffering from chronic acid reflux symptoms and have been unable to keep them under control with diet or medication, reflux surgery may be an appropriate treatment for you. As a sufferer of gastroesophageal reflux disease (GERD), your symptoms usually stem from the improper functioning of the lower esophageal sphincter (LES). The LES is a muscular ring between the stomach and the esophagus that prevents stomach contents from flowing backward or refluxing into the esophagus. Transoral surgery effectively reduces or eliminates symptoms of chronic acid reflux in nearly 90% of cases, making it the most dependable way to ease the discomfort of GERD. Dr. Glenn Ihde specializes in minimally invasive and incisionless reflux surgery procedures that increase patient safety while reducing overall discomfort and recovery time. This allows patients to avoid the cost and inconvenience of lifelong drug therapy by undergoing a reflux surgery that offers less scarring and lower risk of complications than traditional surgeries. Specializing in highly effective procedures such as Laparoscopic Nissen Fundoplication and TIF EsophyX, Dr. Ihde is the surgeon best equipped to handle your transoral surgery in the Dallas, Ft. Worth and Arlington areas. Contact our office today to schedule an appointment with Dr. Ihde or read on for more information regarding individual reflux surgery procedures.

Minimally Invasive Reflux Surgery for GERD

Dr. Ihde practices a minimally invasive procedure known as Laparoscopic Nissen Fundoplication. With proven results in resolving reflux symptoms, Nissen Fundoplication is the most commonly performed reflux surgery for the correction of GERD. The laparoscope is a flexible tube containing a video camera that is introduced through tiny incisions and allows Dr. Ihde to perform the reflux surgery via video monitor. With high success rates, low risk of complication and speedy recovery times, Laparoscopic Nissen Fundoplication is the modern standard in eliminating the symptoms of GERD, but does have some side effects that limit the number of patients willing to undergo the procedure. These side effects are known as the “bloat syndrome”. The good news is that there is a newer procedure called, TIF,  that avoids the bloat syndrome.

Incisionless Reflux Surgery for GERD

Dr. Ihde is at the forefront of a major advancement in GERD treatment called Transoral Incisionless Fundoplication (TIF). Completely eliminating the need for incisions, this revolutionary reflux surgery allows Dr. Ihde to strengthen the LES using an instrument called EsophyX, which can be introduced through the patient’s mouth. This means no internal or external cutting or scarring, greatly reducing the chances of complications and length of hospital stay. Most TIF EsophyX patients experience high rates of success and are able to return to regular activities after just a few days.

Minimally Invasive

Minimally Invasive Transoral Surgery
for GERD Laparoscopic

Nissen Fundoplication Laparoscopic Nissen Fundoplication

A laparoscope is a long flexible tube with a tiny video camera that allows Dr. Ihde to look inside your body to perform surgery without making a large incision. Using the laparoscope, Dr. Ihde introduces special surgical instruments through tiny incisions in the abdomen and performs the surgery while viewing the surgical site on a video monitor.  Nissen Fundoplication is the most frequently performed surgery for gastroesophageal reflux disease (GERD) and provides excellent reduction of GERD symptoms for the majority of patients. Since 1951, Nissen Fundoplication has demonstrated its effectiveness in resolving heartburn-type symptoms in addition to the more unusual symptoms of GERD such as asthma and other upper respiratory conditions. During the Nissen Fundoplication surgery, Dr. Ihde wraps the upper portion of the stomach (fundus) around the base of the esophagus, reinforcing the lower esophageal sphincter and helping it to function normally. Published studies show that between 88 and 95% of patients treated for acid reflux disease with Laparoscopic Nissen Fundoplication, experience reduced GERD symptoms  and, depending on the extent of esophageal damage, medications for GERD can be reduced or stopped.  Although a popular surgery, it’s use has been limited by a side effect called the “bloat syndrome”. Patients feel bloated and distended after surgery but the cause of this is unclear. Fortunately, the newer surgery for acid reflux disease does not induce the bloat syndrome.

Benefits of Laparoscopic Surgery for Acid Reflux Disease

Laparoscopic surgery uses several tiny incisions instead of the single large incision used in a traditional open surgery. This results in:

  • Less discomfort at incision sites
  • Shorter recovery time
  • Shorter hospital stay
  • Smaller, more easily concealed scars
  • Less internal scarring
  • Reduced blood loss and less risk of infection

Incisionless Reflux Surgery with EsophyX

medical-teamTransoral Incisionless Fundoplication (TIF)

Acidic stomach contents flowing backward from the stomach into the esophagus (reflux) cause the symptoms of gastroesophageal reflux disease often referred to as heartburn.  Acid reflux is usually caused by a weakened valve at the junction of the esophagus and stomach. This lower esophageal sphincter (LES) can be strengthened with a surgical procedure called a fundoplication when more conservative treatment has failed. Using an innovative technique called Transoral incisionless fundoplication (TIF), Dr. Glenn Ihde can perform a procedure similar to the Nissen Fundoplication without any incisions through the skin. This revolutionary procedure is a natural orifice surgery that allows Dr. Ihde to repair the LES using an instrument called EsophyX that can be introduced through the patient’s mouth. A typical EsophyX TIF procedure takes only 30 to 40 minutes to reconstruct the anti-reflux barrier and strengthen the LES. In most cases, patients are in the hospital for just one day and can return to normal activities within a few days after the procedure.

What to Expect from EsophyX TIF

Since its approval by the FDA as a treatment for acid reflux disease, EsophyX TIF has demonstrated its effectiveness in eliminating heartburn in 85% of patients. Two year studies show that over 70% of patients remain off their proton pump inhibitor medications (PPIs).

Benefits of EsophyX TIF:

  • Similar effectiveness to laparoscopic procedures
  • No external skin incisions – no scarring
  • No internal cutting or dissecting of the natural anatomy – more rapid recovery
  • Fewer adverse events and complications
  • Does not limit future treatment options
  • Can be revised, if required

EsophyX TIF is suitable for patients who:

  • Have heartburn or non-heartburn acid reflux symptoms two or more times per week
  • No longer respond to acid reflux medications
  • Cannot tolerate the side effects of acid reflux medications
  • Do not wish to use acid reflux medications in the long term
  • Have asthma or a hoarse voice related to acid reflux
  • Have been diagnosed with Barrett’s esophagus
  • Have dental erosions from acid reflux

Patients report a high degree of satisfaction with the EsophyX TIF procedure and its results. The high success rate combined with shorter recovery time and reduced discomfort make this incisionless acid reflux treatment a valuable new option for acid reflux sufferers in Dallas, Fort Worth, and Arlington area.

TIF EsophyX

TIF EsophyX

TIF, Transoral Incisionless Fundoplication is an incisionless surgical procedure that reconstructs the body’s natural physical barrier to reflux. Inserted through the mouth, the esophagus device is used to construct a durable and anti reflux valve. Reestablishing a natural barrier to reflux. TIF is surgery without incisions or the complications associated with more invasive surgical procedures. TIF is performed under constant visualization by the surgeon.

While the patient is under general anesthesia the esophagus device riding over the endoscope is gently guided down through the patient’s mouth into the stomach. The stomach is inflated and the endoscope is advanced and turned so that it’s looking up at the entrance to the stomach. This is where the anti reflux valve will be created. The tissue mold is then advanced into the stomach, the tissue retractor is engaged at the z-line. A line that marks where the stomach and esophagus come together. The tissue is retracted into the tissue mold, some patients may have a small hiatal hernia. A condition where the portion of the stomach has migrated up through the diaphragm into the chest cavity. If present hiatal hernia can be reduced and the esophagus can be lengthened by retracting the endoscope into the esophagus. Suction is then engaged and then the stomach is repositioned down below the diaphragm. The esophagus device is then rotated wrapping the fundus around the lesser curvature of the stomach. Under visual control the esophagus device is then used to deploy two eight shaped fasteners to hold the fold of tissue in place and maintain the wrap. The wrap is then tightened further and the next set of fasteners are placed one centimeter above the z-line. This procedure is repeated on the opposing side. The valve is extended, creating a long three to five centimeter flap and securing it with eight shaped fasteners.

TIF is long lasting the studies show that in the weeks following a nature healing process called transoral-fusion occurs creating a layer of fibrous and fibrous-elastic tissue to bond and secure the tissues faults. Durability of the valve and clinical ethical (SEE) of the valve have been confirmed in long term studies. Clinical results have been excellent comparable to more evasive procedures, but without incisions or the long term complications associated with laparoscopic procedures for reflux.
Do you have questions about GERD Treatment? Contact us now »