Laparoscopic Antireflux Surgery: Total Fundoplication

Approximately 20% of the population in the United States has gastroesophageal reflux disease (GERD). Although most of patients obtain adequate symptomatic control with lifestyle modifications and proton-pump inhibitor (PPI) therapy, some patients will need surgical intervention because they only have partial control of symptoms, do not want to be on long-term medical treatment, or suffer complications related to PPI therapy. In these patients, a laparoscopic Nissen fundoplication aims to control symptoms, improve patients’ quality of life, and prevent GERD complications (bleeding, esophageal stenosis, Barrett’s esophagus, and adenocarcinoma). A properly executed operation is critical to achieve these goals.