What EndoGastric Solutions does

EndoGastric Solutions was a privately held US medical device company founded in 2006 and headquartered in San Mateo, California, that developed the TIF 2.0 (Transoral Incisionless Fundoplication) procedure and the proprietary EsophyX Z+ device for treating Gastroesophageal Reflux Disease (GERD). The company's core technology reconstructs the gastroesophageal flap valve through a flexible endoscope without external incisions, creating an approximately 3 cm, 270-degree esophagogastric fundoplication secured by 20 or more SerosaFuse non-resorbable polypropylene fasteners. An extension called cTIF combines TIF 2.0 with a hiatal hernia repair in a single anesthesia session, broadening the addressable patient population to those with hernias greater than 2 cm.

The company served gastroenterologists and foregut surgeons who perform anti-reflux procedures in hospitals and ambulatory surgery centers, targeting GERD patients unsuitable for proton pump inhibitors or seeking alternatives to traditional surgical fundoplication. Revenue was generated through hardware sales of the EsophyX Z+ device and SerosaFuse fasteners, supported by a six-module physician training curriculum. EndoGastric Solutions raised roughly $320 million across 20 funding rounds between 2006 and 2022 from investors including Advanced Technology Ventures, Canaan Partners, Accelmed, and Vertex Growth Fund, and was acquired by Merit Medical Systems in July 2024 for $105 million, with Merit projecting approximately $30 million in annual sales from the acquired asset.

Name

EndoGastric Solutions

Legal name

EndoGastric Solutions, Inc.

Website

https://endogastricsolutions.com

Company type

Private

Founded year

2006

Operating status

Acquired

Headcount range

51–100 employees

Ownership category

akta.pro rank

Product category

Gastroesophageal Reflux Disease (GERD) Treatment Medical Devices

NAICS

Surgical and Medical Instrument Manufacturing (339112)

SIC

Surgical & Medical Instruments & Apparatus (3841)

akta.pro primary industry

Endoscopic Therapeutic & Access Devices (Trocars, dilators, biopsy/ablation tools) (HLAHADAN)

Keywords

• Endoscopic GERD treatment
• Antireflux medical devices
• Incisionless fundoplication
• Esophagogastric valve reconstruction
• Foregut surgery devices

Headquarters

HQ city

San Mateo

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Hardware or Manufacturing

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Supply Chain

Revenue model

1. EsophyX Z+ Device Sales: EndoGastric Solutions historically generated revenue through the sale of its EsophyX Z+ medical device for treating GERD. The device was acquired by Merit Medical Systems for $105 million, with Merit expecting it to generate approximately $30 million in annual sales.
2. TIF 2.0 Procedure Growth and Adoption: The company raised $18 million in financing to support the growth and adoption of its TIF 2.0 procedure for treating GERD, aiming to expand market reach and improve treatment options for GERD patients.

Go-to-market motion2 records

Distribution channels1 record

Marketing channels5 records

Core offering

EndoGastric Solutions manufactures and commercializes the EsophyX Z+ medical device used during the TIF 2.0 (Transoral Incisionless Fundoplication) procedure to reconstruct the gastroesophageal flap valve and treat GERD without external incisions. The company also developed the cTIF combined procedure and proprietary SerosaFuse fasteners used to create a standardized 270-degree, 3 cm fundoplication under endoscopic visualization.

Product overview

EndoGastric Solutions developed a portfolio of medical devices and procedures for treating Gastroesophageal Reflux Disease (GERD). The core offering consists of the TIF 2.0® (Transoral Incisionless Fundoplication) procedure using the EsophyX Z+® device, which provides a minimally invasive endoscopic alternative to traditional fundoplication surgery. The EsophyX Z+ device uses proprietary SerosaFuse® polypropylene fasteners to create a 270°, 3 cm fundoplication that reconstructs the gastroesophageal flap valve. An extension called cTIF combines the TIF procedure with hiatal hernia repair for patients with larger hernias. The company was acquired by Merit Medical Systems in 2024 for $105 million.

Differentiator

Problem solved

Functional benefit

Brands

• TIF 2.0: Transoral Incisionless Fundoplication procedure for treating GERD without external incisions

Products and services

• TIF 2.0 (Transoral Incisionless Fundoplication) Procedure An advanced endoscopic treatment that reconstructs the gastroesophageal flap valve (GEFV) to restore the natural antireflux barrier without external incisions. It creates a 3 cm, 270-degree fundoplication using the EsophyX Z+ device, intended for gastroenterologists and foregut surgeons treating GERD patients who are unsuitable for proton pump inhibitors or seeking an alternative to traditional surgical fundoplication.
• EsophyX Z+ Device A specialized endoscopic medical device used during the TIF 2.0 procedure that employs proprietary tissue manipulation technology to place SerosaFuse fasteners, creating a reproducible omega-shaped gastroesophageal flap valve under direct endoscopic visualization. Sold to hospitals and ambulatory surgery centers for use by gastroenterologists and foregut surgeons.
• cTIF (Consecutive Transoral Incisionless Fundoplication) Procedure A combined approach in which the TIF 2.0 procedure is performed consecutively with a hiatal hernia repair during the same anesthesia session, allowing restoration of both the antireflux barrier and diaphragmatic integrity for GERD patients with hiatal hernias greater than 2 cm.
• SerosaFuse Fasteners Non-resorbable polypropylene fasteners with tensile strength equivalent to 3-0 suture, used to secure the fundoplication wrap during the TIF 2.0 procedure. Biocompatible and designed to minimize local inflammation while supporting natural tissue healing, with even placement to enable consistent wrap formation and long-term performance.

Quantifiable outcome

• The TIF 2.0 procedure creates an approximately 3 cm, 270-degree esophagogastric fundoplication using 20+ SerosaFuse fasteners.
• +2 more outcomes

Segments1 record

Ideal customer profiles1 record

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

One partnership is on record.

• Merit Medical SystemscoreOEM/ Whitelabel/ Licensing Partner · 2 July 2024Merit Medical Systems acquired EndoGastric Solutions' acid reflux treatment device Esophyx Z+ for $105 million in July 2024. This acquisition transfers ownership of the TIF 2.0 procedure technology and EsophyX Z+ device from EndoGastric Solutions to Merit Medical. Merit expects the acquired device to generate approximately $30 million in annual sales.

Scale indicators4 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Stryker: Stryker is a major medical device company with a presence in endoscopy, surgical instrumentation, and GI OR equipment. As a broad incumbent with hospital sales channels, it competes for the same procedural budgets and accounts as the EsophyX Z+ platform.
• Pentax Medical (HOYA): Pentax Medical manufactures flexible endoscopes and GI endoscopy accessories used during TIF 2.0 and other anti-reflux procedures. It competes with Olympus in endoscopy and has overlapping presence in GI therapeutic devices.
• Ethicon (Johnson & Johnson): Ethicon manufactures laparoscopic instruments and energy devices used in traditional Nissen fundoplication surgery, the incumbent procedure that TIF 2.0 competes against. As the dominant surgical instrumentation supplier for general and foregut surgery, Ethicon is the most established alternative in the anti-reflux surgery market.
• Covidien (now Medtronic): Covidien's legacy portfolio included laparoscopic instrumentation and energy devices used in anti-reflux surgery, now integrated into Medtronic. Relevant as a broad incumbent in minimally invasive foregut surgery.
• Fujifilm Healthcare: Fujifilm Healthcare produces endoscopy systems and accessories used in GI procedures including TIF 2.0. It is one of three major endoscope OEMs globally and competes in adjacent GI therapeutic device categories.
• Olympus Corporation: Olympus is the global leader in flexible endoscopy systems, which are required to perform the TIF 2.0 procedure with the EsophyX Z+ device. Olympus also develops its own GI therapeutic devices and endoscopic surgery platforms that overlap with EndoGastric Solutions' clinical workflow.

Direct peers

• Medtronic: Medtronic markets the LINX Reflux Management System, a magnetic sphincter augmentation device for GERD that competes directly with TIF 2.0 as an alternative to traditional fundoplication. Both target the PPI-refractory GERD patient population seeking minimally invasive, anatomy-preserving solutions.

Emerging players

• Apollo Endosurgery: Apollo Endosurgery develops endoscopic suturing and minimally invasive devices for GI procedures including endoscopic fundoplication and bariatric interventions. It overlaps with TIF 2.0 in the endoscopic anti-reflux and GI therapeutic space.
• Diversatek Healthcare: Diversatek Healthcare manufactures esophageal diagnostic and therapeutic devices including manometry and impedance/pH systems used in GERD workup. Its products support the diagnostic pathway that identifies TIF 2.0 candidates, making it both a complementary and adjacent competitor.
• EndoStim: EndoStim developed an implantable neurostimulation device for GERD that targets the lower esophageal sphincter. As an emerging player in device-based GERD therapy, it addresses the same PPI-refractory patient population using a different mechanism (electrical stimulation rather than anatomic reconstruction).

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/EndoGastricSolutions
• LinkedInlinkedin.com/company/endogastric-solutions

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds22 records

Investors13 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about EndoGastric Solutions