In June of 1988 the first laparoscopic cholecystectomy (gallbladder removal) performed in the United States launched a revolution in surgery. That procedure, performed by my good friend J. Barry McKernan, MD, PhD in Marietta, Georgia was the first step in moving surgery from large open incisions to the era of minimally invasive techniques. For the next twenty years surgeons have used laparoscopic techniques, with their tiny incisions, to perform a wide variety of procedures with minimal trauma and rapid recovery. But now there is a new surgical technique for treating the common problem of chronic heartburn that is performed with NO INCISIONS!

The Transoral Incisionless Fundoplication (TIF) procedure is performed entirely through the mouth using an innovative device called EsophyX2, which fits over a standard flexible endoscope. Using this device the surgeon can recreate a functional anti-reflux valve that keeps stomach acid from the sensitive lining of lower esophagus. This procedure represents the first in what promises to become an entirely new category of surgical procedures known as Natural Orifice Surgery (NOS). One can only image the possibilities as various operations that once required large pain incisions and lengthy recoveries becomes possible with no scars or pain. The future is filled with such dreams and it is exciting to be a part of this revolutionary process.