Laparoscopic fundoplication for GERD: are we there yet?

Area of Science:

• Gastroenterology
• Surgical Innovation

Background:

• Proton pump inhibitors (PPIs) are the primary treatment for gastroesophageal reflux disease (GERD).
• Long-term PPI use presents challenges, necessitating exploration of alternative therapies.
• The need for definitive GERD treatment is growing.

Purpose of the Study:

• To evaluate laparoscopic antireflux surgery as a definitive treatment for GERD.
• To assess the safety and efficacy of surgical fundoplication compared to medical management.
• To determine the long-term outcomes of surgical intervention for GERD.

Main Methods:

• Review of global results and multiple case series on laparoscopic antireflux surgery.
• Analysis of intra- and postoperative morbidity rates.
• Assessment of short-term and long-term symptom alleviation following surgery.

Main Results:

• Laparoscopic antireflux surgery demonstrates a low incidence of morbidity in experienced hands.
• Patients experience a short postoperative hospital stay, averaging 2 days.
• High rates of symptom alleviation were observed: 82% very good and 92% good outcomes.

Conclusions:

• Surgical fundoplication is a safe and effective alternative to long-term medical treatment for GERD.
• The procedure offers significant immediate and long-term symptom relief.
• Careful patient selection, thorough preoperative evaluation, and experienced surgical teams are crucial for optimal outcomes.