General guidelines for your Transoral Incisionless Fundoplication
Why it’s performed:
Our Gastroenterologists use the TIF device for patients who have symptoms of heartburn or
regurgitation. These symptoms occur because stomach acid backs up into the esophagus.
Patients with GERD symptoms who respond to proton pump inhibitors or other antacid
medications but who wish to avoid dependency on these medications are candidates for TIF. In
addition, patients in whom medications are no longer effective or do not provide complete
relief may also benefit from this procedure.
Prior to Procedure:
• The hospital will call you a few days before your procedure to tell you what time to
arrive. If you need information prior to receiving this call you can call the endoscopy
schedulers at 732-253-3210 or the hospital endoscopy nursing line at 732-828-3000 x
5453.
• Arrival times are given to admit you to the unit and prepare you for your procedure. Is
it important that you arrive at your given time. Please Note: Unlike surgery centers this
unit treats both inpatients and outpatients and emergencies may arise that may cause
delays in scheduled procedure. Please be patient and know that we will provide you with
the best care when you go into your procedure. Due to the unpredictable nature of
procedure units, please be prepared to spend the day here.
• Some procedures or recoveries require a hospitalization that we may not always be able
to predict be prepared to stay in the hospital if necessary.
• Do not bring any valuables or wear any jewelry the day of your procedure as we do not
have space for you to secure belongings.
• Because you will be sedated for the procedure you will need to bring someone with you
to take you home. You cannot drive or take public transportation alone for 24 hours
after the procedure. We have limited space in the waiting area and we only can allow
one visitor to wait during your procedure.
• If you need to send proof of your COVID vaccine please email it to
Medications
• If you are taking medications for high blood pressure, seizures, or if you are taking
prednisone, you may take these medications the morning of the procedure or at least 2
hours before the procedure with a small sip of water.
• If you are diabetic:
o If you take a “sugar” pill, do not take it on the day of your procedure.
o If you are taking regular insulin (R), do not take it on the day of your procedure.
o If you are taking any other insulin preparation, please contact your prescribing
physician for instructions.
• If you are taking Coumadin, Plavix, or other blood thinners contact your prescribing
physician for instructions on when to stop taking this medication.
• If you are taking aspirin daily continue to take this medication.
• Tell your doctor if you have allergies
Prep/Diet
• Do not eat or drink anything 8 hours before your procedure to clear your esophagus of
food products.
Day of the procedure:
Your procedure will be done at Robert Wood Johnson University Hospital in the endoscopy suite on the
second floor above Walgreens. The address is:
1 Robert Wood Johnson Place
New Brunswick, NJ 08901
If you are going to be late to your appointment or have any questions the day of the procedure please
call 732-828-3000 x3210.
Arrive 1 ½ hours prior to your scheduled procedure time. When you arrive, you will register and
give your medical history. You will need a responsible adult with you who will accompany you
home. Bring with you a photo ID, insurance card, a list of medications that you take, and a copy
of your COVID vaccine card or a negative PCR COVID test result.
PARKING
• Park in the hospital parking lot located on Little Albany Street and take the elevator to
the 1
st
floor. Bring your parking ticket with you when you enter the hospital. You can
stop at the information desk on the 1
st
floor and have your parking validated for a flat
rate of $6.00. Turn left as you exit the elevator on the 1
st
floor and take the North
building elevators located in the main lobby to the 2
nd
floor. When you get out of the
elevators make a right and another quick right. At the end of that hallway make a left,
pass the Cardiac Cath lab and a set of elevators on your right. You will then see the
Endoscopy department on your left-hand side above Walgreens and Starbucks.
During TIF:
• We will start an IV into your vein to administer fluids, anesthesia and any other
needed medications.
• We will pass the endoscope and TIF device through your mouth into your
stomach. Your doctor will observe images on a screen.
• The TIF device will be used to wrap the top of the stomach around the
esophagus about 270 degrees to create a new valve.
• The new valve will be secured with durable plastic fasteners (staples) that
remain in the body.
• The TIF device and endoscope will be removed through the mouth at the end of
the procedure.
Post Procedure:
Once the procedure is finished you will recover from anesthesia in the endoscopy unit. Your
doctor will discuss the procedure with you. Please be advised, it is common after receiving
anesthesia to forget some of the conversation you had with your doctor. For this reason, we
suggest a family member be available for this conversation at your request.
After the procedure you might have a brief stay in the hospital or you may be discharged home
if you feel well.
If you are discharged home, do not drive, operate heavy machinery, or drink alcohol for
24hours. You should go home and rest after your procedure.
Please refer to the separate handout for full post-procedure dietary instructions.
Call your doctor right away for:
• Severe or new onset abdominal pain that doesn’t improve by passing gas
• Rectal bleeding that turns the entire toilet bowel red
• Fever greater than 101.5 or chills
• Vomiting blood, black or coffee ground looking material
• Severe dizziness, fainting or chest pain
Commonly Reported Post-Procedure Symptoms:
• Sore throat
• Shoulder pain
• Minimal chest pain
• Minimal chance of bleeding
Please Note: These symptoms usually resolve on their own within 24-72 hours after your
procedure. If your symptoms are severe or persist please notify your physician or go to the
emergency department.
Medications after discharge:
• Antacid medications: please continue pre-procedure dose until your first office visit
• Only as needed medications:
o Pain:
o Liquid Tylenol with codeine up to 15ml every 6 hours for your post-
procedure pain
o Nausea:
o Zofran (Ondansetron) 5ml (4mg) every 4 hours, or 8mg every 8 hours
You can resume your daily medications following your procedure. If you are taking any
medications that thin your blood discuss with your doctor when to resume these medications.
Commonly prescribed blood thinners:
• Rivaroxaban (Xarelto)
• Dabigatran (Pradaxa)
• Apixaban (Eliquis)
• Heparin
• Warfarin (Coumadin)
• Clopidogrel (Plavix)
• Aspirin
• Enoxaparin (Lovenox)
• Ticagrelor (Brilinta)
Diet:
Please refer to the separate handout for full post-procedure dietary instructions.
Follow-Up:
Contact your physician to schedule a follow up appointment 3 weeks post procedure and 6 weeks post
procedure:
Clinical Academic Building (CAB)
125 Paterson Street
Suite 5100B
New Brunswick, NJ 08901
Phone: 732-235-7784
IMPORTANT PHONE NUMBERS:
Rutgers GI Clinic: 732-235-7784
Robert Wood Johnson Schedulers: 732-828-3000 x3210
RWJ Endoscopy Nurse line: 732-828-3000 x5453 (Leave a message and you will receive a call
back within 24 business hours)
For after hour emergencies call 732-235-7784
One Robert Wood Johnson Place
New Brunswick, NJ 08903
732.828.3000
rwjbh.org/newbrunswick
Frequently Asked Questions
1. How much pain or nausea will I be in?
This varies from person to person. Generally the pain is more of soreness than a pain. It should not
last for more than a few days. The pain medications given should help. For nausea, the prescribed
medications should help. The nausea should not last more than 2-3 days.
2. I’m feeling tired or fatigued after the procedure?
You are likely dehydrated. Make sure you have a sip to sips of water every five to ten minutes.
You may need water infused with electrolytes
3. I have a fever is that normal?
A fever less than 101.5 post procedure the first three days can be normal, if persistent or higher
than 101.5 degrees please call the office. You can take Tylenol every 6hours (but remember there is
Tylenol in the codeine so DO NOT take both).
4. How much pain is “ok”?
Discomfort is normal post procedure, pain that persists, worsens or if you have abdominal
distension or shortness of breath you need to call the office. Remember you can take Tylenol with
codeine or liquid Tylenol.
5. I haven’t had a bowel movement in a few days?
Try taking miralax, it can be taken daily or up to twice a day. You can also add Senna 1-2 tabs at
bedtime. Again increase your water intake.
6. I am still hungry?
You need to increase your protein intake. Liquids may not make one full. Once you start eating
solids this should resolve.
7. When is it ok to resume exercise?
Walking is permitted and encouraged after your procedure. Begin to walk short distances and
gradually increase the distance and duration of your walks until you feel back to normal. At this
time, you may also climb stairs. In order to give your valve time to heal and fuse, lifting anything
over 5 pounds should absolutely be avoided for the first 2 weeks. During week 3-6, you may lift
items up to 25 pounds and beginning in week 7 you may lift items as you normally would. Sports
and other intense exercise should be avoided the first 6 weeks post-procedure.
8. When is it ok to drive?
One Robert Wood Johnson Place
New Brunswick, NJ 08903
732.828.3000
rwjbh.org/newbrunswick
Driving may be resumed 1-2 days after the procedure. You should not drive if you are taking
prescription pain medication, are experiencing fatigue, or are in significant pain.
9. When can I resume sexual activity?
Sex may be resumed after 7 days.
10. How soon can I return to work?
This is completely up to you. People vary and can return from the very next day to a few days later
to several weeks later.
