Robotic Laparoscopic Gastroesophageal Valvuloplasty (Modified Belsey Fundoplication) for Gastroesophageal Reflux Disease

Before the development of laparoscopic antireflux surgery, fewer than 10,000 antireflux procedures were performed annually in the United States. With the laparoscopic procedures, over 50,000 procedures are performed per year. This change has occurred for four reasons: 1. Gastroesophageal reflux disease (GERD) is a very common disease. 2. Antireflux surgery has been shown to be curative rather than palliative. 3. Minimally invasive techniques have made surgery more acceptable. Clinical studies of laparoscopic Nissen fundoplication have documented that the procedure can be performed with outcomes similar to the 90% rate which was achieved by open procedures but with significantly less morbidity. 4. A clear link between esophageal cancer and GERD has been established. Interestingly, the rates of esophageal adenocarcinoma have continued to rise in the face of H2 antagonists and protein pump inhibitors. Consequently, there has been a greater interest in surgical procedures which can stop GERD and perhaps prevent esophageal cancers.