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The transoral incisionless fundoplication is a minimally invasive treatment for gastroesophageal reflux disease (GERD) that is performed in the outpatient setting. The TIF procedure is performed from inside the patient’s stomach without incisions. This procedure delivers patient outcomes similar to those provided by conventional ARS procedures, but is less invasive, has fewer adverse effects, and does not limit future treatment options. Following the principles of ARS, the TIF procedure repairs the anti-reflux barrier by reducing a hiatal hernia (≤ 2 cm), and creating a valve 2 to 4 cm in length and greater than 270 degree circumferential wrap, thus restoring the dynamics of the angle of His.