Natural Orifice Surgery and Transoral Incisionless Fundoplication

The ASGS supports the continued development of natural orifice surgery, provided these new procedures are consistent with fundamental surgical principles. Over the last several years a number of procedures have been introduced as natural orifice options for the treatment of gastroesophageal reflux disease (GERD). Most of these procedures involved techniques that were not based on sound surgical procedures and have subsequently failed to meet clinical expectations. As a result the field of endoscopic antireflux surgery has been widely labeled as ineffective or experimental by many within the medical community as well as third party payers. However, the transoral incisionless fundoplication (TIF) stands in sharp contrast to other natural orifice options in that it adheres to the fundamental surgical principle, which has guidedsurgical care for GERD for more than 50 years; specifically the creation of a full thickness gastric fundoplication in support of the lower esophageal sphincter. In clinical studies the TIF procedure has been shown to offercomparable results to more traditional procedures in the tratment of selected patients with GERD. The ASGS supports the continued development and refinement of this procedure as well as other appropriate natural orifice procedures performed by adequately trained General Surgeon Specialists.

The ASGS Board of Trustees