Life-Changing Reflux Relief: TIF & Hiatal Hernia Repair Patient

Robert Gussman grew up in Southeast Texas, near the Louisiana border, where he developed a lifelong love for Tex-Mex and Cajun food. “I love spicy foods. I love Tex-Mex, I love crawfish,” he said.

But as Robert approached 60, his favorite foods started causing heartburn for the oil and gas environmental manager who now lives in Tomball, Texas.

“I had a lot of acid reflux - burning and heartburn all the time, stomach aches and everything else that goes along with reflux,” he said. An endoscopy revealed inflammation in Robert's esophagus, along with a hiatal hernia. Medications were no longer controlling the problem, so he sought treatment from Advanced Endoscopist and Gastroenterologist Fares Ayoub, MD, at St. Luke’s Health – Sugar Land.

“Mr. Gussman had a hiatal hernia, where the top part of his stomach slipped up into his chest. It was contributing to a loosening of his lower esophageal valve, allowing food and acid to reflux into the esophagus,” Dr. Ayoub explained. 

Robert was a candidate for an advanced procedure called transoral incisionless fundoplication concomitant with hiatal hernia repair, designed to restore the body’s natural anti-reflux barrier. The procedure was performed by Dr. Ayoub and Advanced Minimally Invasive Foregut Surgeon Brandon Fadner, MD, who worked together to restore the normal anatomic configuration where the esophagus meets the stomach.

First, Dr. Fadner made five small incisions in the abdomen and gently realigned the esophagus and the stomach. “By doing so, we returned the esophagus and stomach to their native anatomical position,” he said.  He then used sutures to repair the hiatal hernia.

Next, Dr. Ayoub used a specialized endoscopic device to retighten the loose lower esophageal sphincter. The procedure takes approximately one and a half hours to complete. Robert was discharged the next day with instructions to follow a blenderized diet for the first two weeks and to avoid heavy lifting for six weeks. 

“Go get this procedure,” Robert advised patients. “I highly recommend it, especially if you're going to continue to eat spicy foods.  This is a procedure you will need because the reflux is just going to get worse without it,” he insisted.

Patients undergoing the cTIF procedure have faster recovery times and fewer side effects than traditional reflux surgery. The St. Luke’s Health - Sugar Land team, which also includes Advanced Gastroenterologist Kalpesh Patel, MD, has successfully performed the procedure hundreds of times in the last three years. Drs. Patel and Fadner worked closely to refine the cTIF combination approach to address two medical issues - acid reflux and hiatal hernia - in the same procedure. 

“By combining our laparoscopic expertise in hernia repair with our expertise in endoscopic fundoplication, we can repair the underlying cause of their chronic acid reflux with minimal side effects,” Dr. Patel said.

Since his procedure eight months ago, Robert hasn’t had a single bout of acid reflux. “I feel so much better now. And, it’s made me more aware of the importance of diet and exercise,” he said. Robert joined the gym and watches what he eats, but when he does enjoy an occasional spicy meal, he does so without worry.

“I just got back from Louisiana,” he said. “I ate Cajun food and never had a problem. This procedure changed my life.”

Ready to explore your long-term options for acid reflux? Contact the General & Bariatric Surgery Clinic at Baylor St. Luke's Medical Group in Sugar Land, Texas, at (281) 637-9000 or find a doctor near you to schedule a consultation with our experienced gastroenterology and surgical team.