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Transoral Incisionless Fundoplication (TIF)

TIF is the newest and most advanced treatment for chronic acid reflux (GERD).

Dr. Goldberg was the first surgeon in Middle Tennessee to perform the TIF Procedure for Acid Reflux. He remains the highest volume surgeon for the TIF Procedure in the Nashville area. He is considered the best surgeon for hiatal hernia repairs combined with the TIF procedure. Out of town patients are welcome. 




Transoral Incisionless Fundoplication is a minimally invasive treatment for gastroesophageal reflux disease (GERD). This procedure is performed through the mouth. It is usually combined with a hiatal hernia repair. It has demonstrated long term relief in multiple national studies. It has been performed worldwide in over 22,000 patients. Approximately 80% of patients remain off of their PPIs for beyond 5 years. Results are even better when you repair your hiatal hernia at the same time. TIF has a very low side effect profile compared to other traditional surgeries like the Nissen Fundoplication. There is virtually no long term dysphagia or Gas Bloat Syndrome.


Do you suffer from chronic acid reflux? Have you already tried pharmaceutical therapies with no or poor results? Are you unable to enjoy the food and drink that you enjoy because of your reflux?  Are you tired of sleeping upright? Do you have Barrett's Esophagus? Are you concerned about long term side effects of medications?

Are you looking for a procedure to definitively cure your reflux? You may be a candidate for TIF.


A specially designed device (The Esophyx Z) is passed through the mouth over an endoscope. The scope is then positioned to view the junction between the esophagus and the stomach. I will pull down the tissue from the gastroesophageal valve and wrap the tissue around the device to make a new valve. This valve is typically secured with 30-40 fasteners (SerosaFuse fasteners) which are comprised of a traditional permanent suture. These fasteners hold the repair in place while the tissue heals and fuses together to form a long lasting repair.


Patients are placed on a specially designed diet. I will have you on a full liquid diet for two weeks. 5 ounces of liquid every 1-2 hours to maintain nutrition and hydration is recommended. After two weeks most patients are advanced to a soft diet for 4 more weeks. You may then eat anything you like as tolerated at six weeks. 

I recommend you avoid heavy lifting or straining the abdominal muscles for 6 weeks while your new valve heals. Avoid mowing the lawn or riding a lawn mower or tractor. You may return to normal light activity as soon as you feel up to it. Most people take up to a week off from work until they feel comfortable driving. If you work remotely, you may work the next day if you feel up to it. This is really up to the individual patient.

Most patients experience mild chest pressure and shoulder blade discomfort for several days. This will resolve typically within the first week or two, but may take a little longer in some patients depending on the size of any combined hiatal hernia repair.

The TIF Procedure
TIF -  Dr. Keith Goldberg
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