The indication for antireflux surgery despite consequent PPI medication includes: persisting disease with non-acid associated symptoms, such as volume reflux, recurrent hoarseness bronchiopulmonal reflux symptoms, incompliance with PPI, recurrent or persisting esophagitis. Our standard procedure is the short full Nissen wrap. Only in a 70% esophageal pump disturbance we actually apply a partial Toupet wrap. In 412 operations (Nissen 82%, Toupet 18%) during one year we observed 1.9% persisting postoperative dysphagia, 5% reflux relapses and 2% gas bloat syndrome of which 1 patient (0.2 %) was re-operated. Significant differences between both procedures regarding the rate of function and complication have not been seen. Quality of life nearly came up to that of non-operated healthy patients and was much better than before surgery. The high acceptance of laparoscopic antireflux surgery in a highly selected collective caused a revival of antireflux surgery by minimal invasive methods.

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