Fundoplication for Gastroesophageal Reflux Disease

Joel M. Sternbach, Nathaniel J. Soper

Research output: Chapter in Book/Report/Conference proceedingChapter


Gastroesophageal reflux disease (GERD) is the most common disorder of the esophagus and gastroesophageal junction. While transient reflux of stomach contents into the esophagus occurs physiologically, the criteria for GERD are met when reflux causes troublesome symptoms and/or complications. With 60% of American adults reporting intermittent heartburn symptoms, GERD is a serious health concern in the Western world. For the 20% of Americans who describe weekly reflux symptoms, GERD increases the risk for esophageal stricture, Barrett esophagus, and esophageal cancer, while significantly affecting health-related quality of life and work productivity. The single most important factor in the development of GERD is an incompetent lower esophageal sphincter. Progressive dilation plus deterioration of the gastroesophageal flap-valve mechanism results in loss of the anatomic antireflux barrier and allows for acid and bile reflux. The goal of antireflux surgery is to reestablish the competency of the lower esophageal sphincter while preserving the patient's normal swallowing capacity. The current gold standard for the operative treatment of GERD is the laparoscopic Nissen fundoplication. This well-established procedure has proved to be both durable and safe over a period of more than 25 years. This chapter discusses the indications and technical aspects of laparoscopic and open fundoplication for the treatment of GERD.

Original languageEnglish (US)
Title of host publicationShackelford's Surgery of the Alimentary Tract
Subtitle of host publication2 Volume Set
Number of pages14
ISBN (Electronic)9780323402323
ISBN (Print)9780323531771
StatePublished - Jan 1 2019
Externally publishedYes


  • fundoplication
  • Gastroesophageal reflux disease (GERD)
  • laparoscopic antireflux surgery
  • Nissen

ASJC Scopus subject areas

  • General Medicine


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