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The ability to perform a fundoplication laparoscopically since 1991 has changed the surgical approach to patients with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery remains an excellent option in patients with severe GERD. Laparoscopic Nissen fundoplication offers less morbidity and mortality than the open procedure with at least the same short-term outcome and better results compared to medical therapy. The rate of conversion to an open procedure is now close to zero. Appropriate preoperative investigation, patient selection and adequate discussion of risks are important in securing a good outcome and long-term patient satisfaction. Some patients have continuing symptoms, but more than 90% of patients remain satisfied with their decision to undergo surgery. This excellent success rate is maintained for up to 20 years after open fundoplication and indications are that this should be the same after the laparoscopic procedure [1], [2]. Long-term results of laparoscopic fundoplication will be discussed under various headings. |
