More than 20 million Americans suffer with daily heartburn or other symptoms of reflux, such as regurgitation, chronic cough, hoarseness and dental erosions.  Until recently, patients faced either a lifetime of daily medications, and often incomplete resolution of their symptoms, or the necessity of invasive surgery to alleviate their symptoms.  Hackensack Meridian Health Hackensack University Medical Center is now offering an alternative.  It is called the TIF ® procedure or Transoral Incisionless Fundoplication and is performed without laparoscopy or open abdominal incisions.

“The TIF procedure can significantly improve the quality of life for our patients who suffer from reflux disease,” said Rosario Ligresti, M.D., FASGE, chief, Division of Gastroenterology, Department of Medicine, Hackensack University Medical Center.  “With the TIF procedure, the anti-reflux barrier is repaired through the mouth with an endoscope, the same equipment used to diagnose GERD.  This is a first for the Division of Gastroenterology, being able to offer natural-orifice surgery in a truly minimally-invasive and cost-effective way.”

The TIF procedure reduces a patient’s hiatal hernia and rebuilds the valve between the stomach and esophagus, restoring the natural, physiological anatomy to prevent GERD. Because the procedure is completely incisionless, there is reduced pain, reduced recovery and no visible scar. In addition, the procedure is performed in an outpatient setting, often with only a brief, overnight stay in the hospital.

“Reflux medications including proton pump inhibitors (PPIs) can help relieve patients’ heartburn symptoms, but do not solve the underlying anatomical problems or prevent further disease progression,” said Fahad Khan, M.D., attending physician, Division of Gastroenterology, Department of Medicine, Hackensack University Medical Center. “Recent studies of the TIF procedure have shown that it can reduce patients’ dependency on medications with 75% of patients completely off their daily medications after three years and experiencing a dramatic improvement in their quality of life.”

The Division of Gastroenterology and the Department of Surgery at Hackensack University Medical Center have partnered to create the Hackensack Center for Esophageal Disease.   The Center’s mission is to comprehensively treat patients with all forms of esophageal disease, including reflux.  Patients are treated for diseases ranging from atypical reflux to Barrett’s esophagus, a pre-malignant condition utilizing a multidisciplinary team and evidenced-based treatments. 

“Hackensack University Medical Center is pleased to offer long term reflux patients this minimally invasive treatment option,” said Martin S. Karpeh, M.D., chair, Department of Surgery, Hackensack University Medical Center.  “We look forward to utilizing this innovative technology to improve patient outcomes.”

About the TIF® Procedure for Reflux

Performed without the need for external incisions through the skin, the TIF procedure offers patients who require an anatomical repair an effective treatment option to correct the underlying cause of GERD.  Studies show that for up to three years after the TIF procedure, esophageal inflammation (esophagitis) is eliminated and most patients are able to stop using daily medications to control symptoms. For more information, please visit

About Hackensack Meridian Health Hackensack University Medical Center

Hackensack Meridian Health Hackensack University Medical Center, a 781-bed nonprofit teaching and research hospital located in Bergen County, NJ, is the largest provider of inpatient and outpatient services in the state. Founded in 1888 as the county’s first hospital, it is now part of one of the largest networks in the state comprised of 33,000 team members and more than 6,500 physicians. Hackensack University Medical Center was listed as one of the top two hospitals in New Jersey in U.S. News & World Report’s 2018-19 Best Hospital rankings. It was also named one of the top five New York Metro Area hospitals. Hackensack University Medical Center is one of only five major academic medical centers in the nation to receive Healthgrades America’s 50 Best Hospitals Award for five or more years in a row. Becker’s Hospital Review recognized Hackensack University Medical Center as one of the 100 Great Hospitals in America 2018. The medical center is one of the top 25 green hospitals in the country according to Practice Greenhealth, and received 25 Gold Seals of Approval™ by The Joint Commission – more than any other hospital in the country. It was the first hospital in New Jersey and second in the nation to become a Magnet® recognized hospital for nursing excellence; receiving its fifth consecutive designation in 2014. Hackensack University Medical Center has created an entire campus of award-winning care, including: the John Theurer Cancer Center; the Heart & Vascular Hospital; and the Sarkis and Siran Gabrellian Women’s and Children’s Pavilion, which houses the Joseph M. Sanzari Children’s Hospital and Donna A. Sanzari Women’s Hospital, which was designed with The Deirdre Imus Environmental Health Center and listed on the Green Guide’s list of Top 10 Green Hospitals in the U.S. Hackensack University Medical Center is the Hometown Hospital of the New York Giants and the New York Red Bulls and is Official Medical Services Provider to The Northern Trust PGA Golf Tournament. It remains committed to its community through fundraising and community events especially the Tackle Kids Cancer Campaign providing much needed research at the Children’s Cancer Institute housed at the Joseph M. Sanzari Children’s Hospital. To learn more, visit