Abstract
Gastroesophageal reflux disease (GERD) is a common disease that accounts for approximately 75 per cent of the pathology of the esophagus. Forty per cent of the adults in the USA have occasional heartburn, and ten per cent experience heartburn daily.1,2 It is estimated that 20 per cent of patients with GERD develop serious complications, such as ulceration, stricture, and Barrett’s metaplasia. Although medical therapy may be effective, it is often required for a protracted period of time. In addition, prolonged therapy often requires escalated dosages, and discontinuation of medications may result in an early recurrence of symptoms. Surgery has improved because of a better understanding of the underlying pathophysiology of GERD and technical refinements of operative techniques.3,4 A controlled, randomized trial showed superiority of surgical therapy for the treatment of severe GERD, with less frequent side effects than with non-surgical management.5