Laparoscopic antireflux surgery for reflux esophagitis

Area of Science:

• Gastroenterology
• Surgical Innovation
• Acid Reflux Management

Background:

• Proton pump inhibitors (PPIs) are first-line for reflux esophagitis, yet over 25% of patients experience persistent gastroesophageal reflux disease (GERD) symptoms.
• Potassium-competitive acid blockers (P-CABs) emerged in 2015 as a newer antisecretory drug class, alongside PPIs and H2 blockers.
• Current medications do not address the underlying cause of GER, which is cardiac insufficiency, necessitating surgical intervention.

Purpose of the Study:

• To present the surgical technique for laparoscopic Toupet fundoplication (LTF).
• To highlight LTF as a preferred surgical option for GERD, especially concerning postoperative dysphagia.

Main Methods:

• Description of the surgical technique for laparoscopic Toupet fundoplication (LTF).
• Focus on the procedure's suitability for managing GERD and associated dysphagia.

Main Results:

• The study details the LTF technique for addressing GERD.
• LTF is identified as a primary surgical choice for managing postoperative dysphagia after antireflux procedures.

Conclusions:

• Antisecretory medications like PPIs and P-CABs do not resolve gastroesophageal reflux (GER).
• Surgical intervention is required to correct the antireflux mechanism insufficiency.
• Laparoscopic Toupet fundoplication (LTF) is a recommended surgical approach for GERD, particularly for patients experiencing postoperative dysphagia.