A Coordinated GI/Surgery Team for Your GERD Patients

Savannah Reflux Surgery is a joint practice between Dr. T. Ellis “Chip” Barnes (robotic surgeon, accredited Master Hernia Surgeon) and Dr. Jonathan Kandiah (advanced gastroenterologist), offering combined Transoral Incisionless Fundoplication (cTIF) as a minimally invasive alternative to Nissen fundoplication for appropriately selected GERD patients.

We work as a coordinated team, surgeon and gastroenterologist together, in a single procedure under one anesthesia. For your patients, that means one operation, one recovery, and one team managing the entire perioperative course.

Direct physician line: 912-350-0566

The Clinical Case for cTIF

Most GERD patients with chronic symptoms have a hiatal hernia, and the hernia is part of what’s driving the reflux. Endoscopic TIF alone doesn’t address that, which is why long-term outcomes for TIF-only have been inconsistent in the literature.

cTIF combines a laparoscopic or robotic hiatal hernia repair with endoscopic fundoplication in a single coordinated procedure. The result is a partial (270°–310°) fundoplication built from inside the stomach, with the hernia properly reduced and the crura repaired. This addresses both mechanical drivers of reflux.

Compared to Nissen, cTIF offers:

  • Lower rates of dysphagia and gas-bloat syndrome due to the partial wrap geometry
  • Preserved ability to belch and vomit
  • Faster recovery — most patients return to normal activity within about a week
  • A reversible/revisable pathway — if cTIF is insufficient long-term, conversion to Nissen remains possible

For severe complex anatomy, such as paraesophageal hernias, hernias greater than 5 cm, severe motility disorders, or complex redo cases, Nissen remains the appropriate option, and we’ll tell you and your patient that directly when it’s the right answer.

Patients Who Might Be cTIF Candidates

Specific profiles:

  • PPI-dependent > 6 months with breakthrough symptoms or escalating doses
  • Patients concerned about long-term PPI side effects (renal, bone density, B12, magnesium, dementia signal)
  • Regurgitation-predominant GERD — typically the symptom least responsive to acid suppression
  • LPR / chronic cough / globus / laryngitis with documented reflux
  • GERD–asthma overlap
  • Hiatal hernia on imaging with reflux symptoms
  • Younger patients facing decades of PPI use
  • Patients who have declined Nissen because of side-effect concerns
  • Post-bariatric reflux (selected cases — please call to discuss)

We’re happy to see any patient where the question is “is there something better than the PPI?” — including those who turn out not to be surgical candidates. A clear “no” with a documented reason is often as useful to you as a “yes.”

What to Expect When You Refer

We’ve built our workflow specifically around two things referring physicians have told us they want: fast scheduling and a closed communication loop.

Steps What To Expect
Initial consultation Typically within 1–2 weeks of referral
Diagnostic workup EGD, pH testing, manometry as indicated, coordinated through our team
Decision and recommendation Communicated to the patient and to you
Procedure scheduling Typically within 2–4 weeks of decision
Post-op letter to referring provider Within 48 hours of procedure
Post-op follow-up We see the patient; we send notes back to you
Long-term GI surveillance Returns to you per your preference

You stay in the loop at every step. You keep the patient.

Co-Management Philosophy

This is your patient, and they return to you for ongoing care. Our role is to handle the diagnostic workup specific to anti-reflux candidacy, perform the procedure, and manage the perioperative period, then return the patient to your care for long-term GI follow-up, surveillance endoscopy, and anything else they need.

If you’d prefer to keep doing the patient’s diagnostic EGD, pH study, or manometry yourself, we’ll happily review your data instead of duplicating it. Just send the reports with the referral.

How to Refer

Three convenient options:

  • EMR / fax referral: 912-350-9037
  • Phone: 912-350-0566 (ask for the referral coordinator)
  • Direct physician line: 912-350-0566 — for clinical questions or complex cases, ask to speak with Dr. Barnes or Dr. Kandiah directly

What to include with the referral:

  • Patient demographics and insurance
  • Brief reflux history and current medications
  • Any prior EGD, pH, or manometry reports (if available)
  • Imaging if a hiatal hernia has been documented

If anything’s missing, we’ll get it. Don’t let incomplete records hold up a referral.

Practice Locations

Main line: 912-350-0566

T. Ellis “Chip” Barnes, MD
Robotic Surgeon
Master Hernia Surgeon (accredited)
4700 Waters Avenue, Building 400
Savannah, Georgia 31404

Jonathan Kandiah, MD
Advanced Gastroenterologist
1139 Lexington Avenue, Suite A
Savannah, GA 31404

Continuing Education and Practice Visits

We’re also glad to:

Present at your practice (lunch-and-learn, grand rounds, departmental meeting)

Review specific cases with you by phone

Host you for an in-person observation of a cTIF procedure

Provide outcomes data for your reference

To arrange any of the above, contact our office at 912-350-0566

We appreciate the trust involved in sending us your patients. If there’s anything we can do to make the process smoother, please tell us.