Transoral incisionless fundoplication (TIF) is a newly offered procedure performed in a hospital setting for the definitive treatment of GERD for patients with small hiatal hernia. The procedure creates a fundoplication (wrap) at the lower esophageal sphincter (LES) to prevent GERD. The TIF may be combined with a surgical repair of a large hiatal hernia at the same setting by a qualified surgeon. TIF is covered by many insurance plans including Medicare and provides a major alternative to surgically performed laparoscopic Nissen fundoplication. TIF has been shown to have less side effects than surgical Nissen, specifically less post-operative difficulty swallowing, gas-bloat syndrome, and inability to belch or vomit.