ABSTRACT
In an attempt to achieve an effective antireflux barrier with fewer side effects, a number of partial fundoplications have been proposed over the years. This chapter focuses on the two most popular of these: the posterior 270-degree fundoplication and the anterior 180-degree fundoplication. The ideal antireflux operation would alleviate reflux by replicating normal physiological function of the lower esophageal sphincter. Surgery creates a mechanical barrier to reflux between the stomach and the esophagus, which is independent of the constituent of the refluxate, whether this is acid based or duodeno-gastric in nature. With a goal of 100" satisfaction among our patient population, potential candidates for antireflux surgery must be properly assessed. The pars flaccida of the lesser omentum is opened and dissected down to the right crus with diathermy, avoiding damage to the hepatic branches of the vagus nerve. Aggressive anti-emesis is administered postoperatively to prevent vomiting.
