Twenty-five children weighing less than 8 kg underwent laparoscopic Ni
ssen fundoplication for treatment of refractory gastroesophageal reflu
x (GER) between January 1993 and April 1995, Mean patient age was 6 mo
nths and weight was 5.1 kg, Mean operative time was 114 min, including
gastrostomy in 20 patients, Nineteen patients are alive without evide
nce of GER with a mean follow-up of 359 days, Perioperative complicati
ons were unusual and mild, There were 6 late deaths due to progression
of underlying disease and not attributable to the procedure, Laparosc
opic Nissen fundoplication provides effective antireflux protection to
very small children with acceptable morbidity and mortality through s
hort-term follow-up.