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Updated: Jun 19, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
Partial posterior wrap (toupet)in patients with defective esophageal body motility
Nabil Ali Gad El-Hak1, Mostafa Abo Zeid, Ahmed Aboelemen
1Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt.
Background:
The effectiveness of partial posterior wrap (Toupet procedure) in patients with defective esophageal body motility is controversial.
Aim Of The Study:
To evaluate the effect of Toupet procedure upon the outcome of laparoscopic (LF) and open (OF) fundoplications in gastroesophageal reflux disease (GERD) patients with defective esophageal body motility.
Patients And Methods:
This study included 32 patients with severe GERD who underwent Toupet procedure; 18 (56.25%) OF 'and 14 (43.75%) LF. Outcome measures included assessment of relief of the symptoms, results of repeated endoscopy, barium study, manometry and pH metry; both early (within six months) and late (two years at least).
Results:
Relief of heartburn was achieved in 26 patients (81.3%). These include 14 (77.7%) and 12 (85.7%) patients who underwent OF and LF respectively. Occasional dysphagia developed in six patients (18.7%) early, and three (9.4%) late; all were managed conservatively. Endoscopic esophagitis healed in 26 patients (81.3%); 14 (77.7%) OF and 12 (85.7%) LF. Mean LES and body pressures improved (10.5 to 17.7 and 29.0 to 41.0 mmHg respectively). Persistent acid reflux was detected in six patients (18.7%); two (22.3%) OF and two (14.3%) LF.
Conclusion:
Toupet fundoplication is an effective procedure for reflux control except in patients with severe GERD.
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