In the Western world gastroesophageal reflux disease constitutes the s
ingle most common benign disorder of the upper gastrointestinal tract.
Current medical therapy with proton pump inhibitors allows physicians
to provide complete symptom relief and healing of acute esophageal mu
cosal injury in practically all affected patients. However, up to 50 %
of patients require maintenance therapy to prevent relapse. In these
patients laparoscopic antireflux surgery offers an attractive and cost
-effective alternative to potentially life-long medical therapy. Conse
quently, every patient with persistent or recurrent symptoms and/or co
mplications of gastroesophageal reflux who depends on maintenance medi
cal therapy to remain in remission is a potential candidate for laparo
scopic antireflux surgery, particularly if of young age, suffering fro
m side effects of medical therapy or worrying about long-term safety o
f the conservative treatment alternatives. A careful selection of pati
ents, objective documentation of gastroesophageal reflux disease by 24
-h esophageal pH monitoring, and meticulous attention to the technical
details of the procedure are essential for a successful outcome of an
tireflux surgery.