Health Problem: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders in the United States and Europe. The prevalence of GERD is estimated at 8.8% to 25.9% in Europe and 18.1% to 27.8% in North America. GERD is defined by the presence of chronic symptoms or mucosal damage caused by an abnormal reflux of gastric contents into the esophagus.

Technology Description: Laparoscopic fundoplication is a minimal access surgical procedure for patients with long-standing GERD. A range of laparoscopic procedures are now used for the treatment of GERD; these include total (Nissen) fundoplication and various types of partial fundoplication. Opinions differ about which procedure achieves the best outcome.

Controversy: Partial fundoplications have been reported to have superior GERD-related symptom control postsurgery, but evidence of long-term durability remains to be demonstrated.

Key Questions:

  • Is partial laparoscopic fundoplication an effective alternative to laparoscopic Nissen fundoplication (LNF) in patients with long-standing GERD that is refractory to medical treatment?
  • Is partial laparoscopic fundoplication safe when compared with LNF?
  • Have definitive patient selection criteria for laparoscopic partial fundoplication and LNF for GERD been established?

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