Local doctor discusses minimally invasive acid reflux surgery

IRON RIVER — Gastroesphageal reflux disease, or acid reflux, is one of the most common digestive diseases not only in the United States, but in the world. More severe cases of acid reflux require surgical intervention, through laparoscopy or open abdominal incisions.

Doctors at Aspirus Iron River Hospital have become certified in surgical options that are less invasive than traditional treatment surgeries. Dr. Medhat Fanous M.D., the director of Acid Reflux Services, has performed hundreds of these minimally invasive treatments.

“We do the traditional acid reflux surgery as well as the cutting-edge new techniques and we have more than one modalities that we do through the mouth so that the patient doesn’t have incisions,” said Dr. Fanous.

The lack of incisions shortens the amount of pain a patient could experience after the surgery. A report published in a medical journal back on December 21st, 2017 describes one of these less invasive procedures, called transoral incisionless fundoplication, or TIF.

During the TIF procedure, a flexible endoscope is inserted into the patient’s mouth. The endoscope takes the patient’s own stomach tissue to repair the valve of the esophagus. More specifics on the procedure can be found HERE.

Although this type of surgery is not the best treatment for all cases of acid reflux, the TIF option was right for Mary Kurtz, who is a devout Jehovah’s Witness.

“Our beliefs are not to take in blood, either by digesting it or by any medical use,” said Kurtz. “I am happy that Dr. Fanous went along with it because it is a big thing for us.”

The patient described in the case report is Kurtz, and it was the second TIF procedure that Dr. Fanous had ever done. It has been over two years since Kurtz’s procedure and she experienced no immediate or long-term complications.

“It was the best thing I’d ever done. After two years, I have no pain, I have no acid reflux, I can eat things I never even thought about touching before,” said Kurtz.

Aspirus Iron River houses the only program in the Upper Peninsula that performs these types of procedures and Dr. Fanous said he has seen over 400 patients in the past two years, performing the TIF procedure over 150 times.

“On a personal level, I’ve done so many surgeries and there’s nothing as rewarding as doing the surgeries for acid reflux,” said Dr. Fanous. “The stories that I hear from patients, it’s just amazing how acid reflux controlled their lifestyle. No matter what they did, they did not get any relief and they were not offered options.”

Dr. Fanous said that overall, the outcomes for these surgeries have been successful. The TIF procedure has reportedly worked for up to 60 years, but Dr. Fanous said the minimally invasive procedures do not have the same longevity as the traditional methods.

The TIF procedure is just one way to treat acid reflux.

“What we offer is not for everyone. Everybody has to go through a standardized workup and then we sit down with the patient and tailor the options for them,” said Dr. Fanous.