Putting an end to GERD: Non-surgical TIF procedure stops acid reflux - August 23, 2014

Courtesy of NWI Times

August 23, 2014 10:15 am

IMA Physicians Perform 250th TIF Procedure

Physicians affiliated with Internal Medicine Associates (IMA) were recognized by EndoGastric Solutions Inc. for outstanding achievement for their ongoing contributions to treating and improving the quality of life for patients with Gastroesophageal Reflux Disease (GERD), also known as acid reflux.

Gastroenterologists Daniel B. Hurwich, MD; Peter Mavrelis, MD; Ahmad B. Shughoury, MD; and Kumar Venkat, MD, have performed more than 250 Transoral Incisionless Fundoplication (TIF) procedures, a highly successful, incisionless procedure that treats GERD.

“We believe the TIF procedure fills a therapy gap that exists for GERD patients who take daily therapy and who remain unsatisfied because of incomplete symptom control,” said EndoGastric Solutions CEO, Skip Baldino. “The IMA physician team is recognized nationally as leaders who have embraced new and innovative methods to care for the GERD patients they serve.”

IMA Endoscopy SurgiCenter, PC, entered into a co-management agreement with Methodist Hospitals last year in which the hospital acquired IMA’s Endoscopy SurgiCenter. The co-management arrangement enables Methodist Hospitals to increase the number of endoscopic procedures it performs by more than 2,500 annually.

“Methodist Hospitals congratulates the IMA physicians for this outstanding achievement,” said Methodist Hospitals president and interim CEO, Dr. Michael Davenport. “Our partnership has provided us the opportunity to work with an outstanding group of physicians to continue to deliver excellent care to Northwest Indiana.”

Cathy Reed was suffering from acid reflux, also known as GERD, when she read about the transoral incisionless fundoplication (TIF) procedure in the newspaper. Rather than treating the symptoms of acid reflux as medications do, a TIF procedure addresses the cause…without making a single incision.

“The TIF procedure really interested me because it’s incisionless and can be fixed if it doesn’t work right the first time,” Cathy said.


GERD occurs when the valve between the esophagus and the stomach no longer functions, allowing acid to escape into the esophagus. While medication can be effective for the short-term, it doesn’t treat its underlying cause. With long-term use, those same medications can lose effectiveness or have adverse effects.

“In contrast, surgical correction of the esophageal valve corrects the defect that causes GERD,” said Dr. Peter Mavrelis, a board certified gastroenterologist and internal medicine physician.

The most common conventional surgical treatment for acid reflux, laparoscopic nissen fundoplication, is often performed when a patient also has a hiatal hernia. Unlike medication, this procedure addresses the GERD cause. However, it involves surgical intervention, a hospital stay and, depending upon the approach used, a two- to six-week recovery period.

In contrast, the TIF procedure is completely incisionless. Performed through the mouth under general anesthetic, the surgeon sends a scope down the esophagus and stomach to recreate the barrier between them and prevent reflux. Patients experience less discomfort and a shorter recovery period than with an invasive surgery.

“More and more insurance companies now see the value of TIF over conventional surgery or taking chronic medications,” Dr. Mavrelis said.

Seeking Relief

Just as Cathy’s reflux progressed to the point of being unbearable, she remembered attending a TIF seminar presented by Dr. Mavrelis and scheduled an appointment.

Because Cathy also had a hiatal hernia, Dr. Mavrelis employed a team approach to address her problems. Dr. Tom Galouzis, a general surgeon, repaired the hernia endoscopically, and then Dr. Mavrelis performed the TIF procedure.

“Performing the two procedures in immediate succession is a relatively new concept. In doing so, we achieve the same good results without any of the comorbidities associated with traditional surgeries,” said Dr. Mavrelis.

Just six weeks after her TIF procedure, Dr. Mavrelis told Cathy that her procedure was a success.

“I like being a success – it’s great,” she said.

“Cathy is an excellent example of a satisfied patient,” Dr. Mavrelis said.

“I’m really glad that Methodist offers the TIF procedure,” Cathy said. “It’s nice to have that local expertise so you don’t have to drive back and forth to Chicago or deal with traffic.”