Twenty Years of Laparoscopic Fundoplication for GERD
Posted on 11/10/2011
The first laparoscopic Nissen fundoplication was performed 20 years ago. Surgical management of gastroesophageal reflux disease (GERD) should be offered only toappropriately studied andselected patients, with the ultimate aim of improving the well-being of the individual, the ‘‘quality of life.’’ The choice of fundoplication should be dictated by the surgeon’s preference and experience.
Introduction
The first laparoscopic Nissen fundoplication was performed 20 years ago [1]. During the intervening 20 years, several questions have been raised about the safety and effectivenessofthisoperativeapproach.Isthelaparoscopic fundoplication as safe as the open approach? What’s the best fundoplication? How is the best fundoplication performed? Is it less efficient, equal to, or superior to open surgery? Is it less effective, equivalent to, or superior to medical therapy? Are there some new technologies that might increase the quality of the procedures? During the past 20 years, thousands of scientific articles have been published on these topics, but there are still unanswered questions. The aim of this review is to summarize the evolution of minimally invasive antireflux surgery during the last 20 years, trying to answer some of the questions.
Bernard Dallemagne • Silvana Perretta
Published online: 15 March 2011. Socie´te´ Internationale de Chirurgie
