TIF is an anti-reflux procedure done entirely through the mouth with a device mounted on an endoscope. It folds the top of the stomach around the lower end of the gullet and fixes it with small plastic fasteners, rebuilding the valve that keeps acid in the stomach.
It reduces heartburn and regurgitation and lets many people cut down or stop acid tablets, with fewer gas-related side effects than surgical fundoplication. It is less powerful than surgery, it cannot fix a large hiatal hernia on its own, and a proportion of people return to medication over the years.
What Transoral Incisionless Fundoplication (TIF) involves
Assessment includes an endoscopy to grade oesophagitis and measure any hiatal hernia, 24-hour pH or impedance monitoring to prove acid reflux, and manometry to check that the gullet squeezes normally. Under general anaesthetic, the EsophyX device is passed over a flexible endoscope into the stomach. The endoscope is turned back to view the valve from below. A helical retractor grips the tissue at the junction, the device pulls it down and wraps the stomach wall around the gullet, and polypropylene H-shaped fasteners are fired through both layers. This is repeated around the circumference, placing about 20 fasteners to create a valve 2 to 4 cm long covering 270 degrees or more.
Who is a good candidate for Transoral Incisionless Fundoplication (TIF)?
Best for proven reflux that responds at least partly to tablets, in people with little or no hiatal hernia.
- Typical heartburn or regurgitation with reflux confirmed on pH testing
- Hiatal hernia of 2 cm or less
- Symptoms persisting on acid tablets, or a wish to avoid lifelong medication
- Body mass index below about 35
- Normal or near-normal oesophageal motility
It is usually not the right choice if:
- Hiatal hernia larger than 2 cm, unless it is repaired laparoscopically at the same time
- Severe oesophagitis (grade C or D) or long-segment Barrett's oesophagus
- Major swallowing disorders such as achalasia
- Previous oesophageal or gastric surgery that alters the anatomy
- Symptoms that have never responded to acid suppression, where reflux may not be the cause
Technique options
- TIF 2.0 with EsophyX: The current standard technique creating a partial wrap from inside the stomach.
- Combined cTIF: A surgeon repairs the hiatal hernia laparoscopically, then TIF is done in the same anaesthetic. Used when the hernia exceeds 2 cm.
- Laparoscopic fundoplication: The surgical comparison: stronger and better proven long term, with more bloating and swallowing difficulty.
- Continued medical therapy: A reasonable choice when tablets control symptoms and are well tolerated.
What happens during your treatment
The procedure takes 45 to 75 minutes under general anaesthetic with a breathing tube. There are no skin cuts. Afterwards a sore throat, left shoulder ache and upper abdominal discomfort are common for a few days. Most people stay one night.
Preparing for your trip
Plan about a week: tests in the first 2 days if not already done at home, the procedure, one night in hospital and a check before flying. It is a single session. Bringing recent pH and manometry results can shorten the stay.
- Tell the doctor about medication, allergies, pregnancy or breastfeeding, and any history of cold sores, keloid scars or autoimmune disease
- Avoid alcohol, aspirin and anti-inflammatory painkillers for a few days beforehand if your own doctor agrees, to reduce bruising
- Arrive without make-up on the treatment area and avoid sunbeds and strong sun for two weeks before
Recovery and results
The fasteners need time to heal into place, so diet is staged: liquids for 2 weeks, then soft food for up to 4 more weeks. Avoid heavy lifting, vigorous exercise, retching and coughing fits as far as possible for 6 weeks. Acid tablets are usually continued for 2 weeks, then reduced. Most people return to desk work within a week.
- Back to everyday activity: About 1 week; staged diet for 6 weeks
- When results show: Heartburn often improves within weeks
- How long they last: Several years in most responders; durability varies
Safety, risks and revision policy
Serious complications occur in around 2 percent of cases. Discuss how many procedures the team performs.
- Bleeding at fastener sites
- Perforation of the gullet or stomach, which is rare but serious
- Air around the lung or in the chest
- Temporary difficulty swallowing or chest pain
- Bloating, usually milder than after surgery
- Return of reflux as the wrap loosens, with renewed need for tablets
- Need for later surgical fundoplication, which remains possible
Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.
Cost of Transoral Incisionless Fundoplication (TIF) in Türkiye
Clinic-Y does not publish a single price for Transoral Incisionless Fundoplication (TIF), because the honest figure depends on your case. What moves it:
- The single-use device, which is a major part of the price
- Whether pH monitoring and manometry are included
- Combined laparoscopic hernia repair
- Overnight stay and anaesthetic
Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.
Frequently Asked Questions
Will I be able to stop my acid tablets?
At 3 to 5 years, around half to two thirds of well-selected patients are off daily proton pump inhibitors. Others take a lower dose.
Can I still burp and vomit afterwards?
Usually yes. Because the wrap is partial, gas bloat and inability to belch are much less common than after a full surgical wrap.
Does it help with cough or throat symptoms?
Results for atypical symptoms are less consistent than for heartburn and regurgitation. Objective proof of reflux beforehand is essential.