We Asked the Experts: “When is a Laparoscopic Fundoplication Warranted For Gastroesophageal Reflux Disease?”

At least once or twice per month, we see a patient with debilitating reflux symptoms. Usually it is a patient who describes volume regurgitation occurring on a daily basis, and frequently necessitating sleeping propped up in a recliner. These patients have cut out caffeine, alcohol, spicy foods, and late meals with friends. They take high doses of proton pump inhibitors religiously! When asked how long this has been going on, the answer is variable but, more often than not, many years, if not decades, have passed since the symptoms began. And it is not uncommon for these patients to admit that they themselves insisted on a referral to a surgeon, as they were tired of their poor quality of life with breakthrough symptoms on maximal medical therapy.

So why the hesitation to obtain a surgical opinion? The evidence (described below) is often in favour of anti-reflux surgery...