Journal of Gastrointestinal Surgery

, Volume 17, Issue 4, pp 822–828 | Cite as

Laparoscopic Total Fundoplication for Gastroesophageal Reflux Disease. How I Do It

  • Marco E. Allaix
  • Fernando A. Herbella
  • Marco G. Patti
How I do it



A laparoscopic fundoplication is considered today the procedure of choice for the treatment of gastroesophageal reflux disease (GERD).


Several eponyms are used in the literature to denote different antireflux operations: Nissen, Nissen-Rossetti, Toupet, Lind, Guarner, Hill, and Dor. We feel that it is more important to focus on the technical elements which make a fundoplication effective and long lasting. The type of fundoplication (total vs. partial) is tailored to the quality of esophageal peristalsis as documented by the preoperative manometry. In the USA, a partial fundoplication is chosen only for patients with very impaired or absent esophageal peristalsis.


This article describes the technique of laparoscopic total fundoplication for GERD. Partial fundoplication is performed following the same technical elements as the total fundoplication. A 240° to 270° wrap rather than a 360° wrap is performed.


Gastroesophageal reflux disease Laparoscopic Nissen fundoplication Total fundoplication Partial fundoplication Toupet fundoplication Guarner fundoplication Dor fundoplication 


Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Marco E. Allaix
    • 1
  • Fernando A. Herbella
    • 1
  • Marco G. Patti
    • 1
  1. 1.Department of Surgery and Center for Esophageal DiseasesUniversity of Chicago Pritzker School of MedicineChicagoUSA

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