A complete evaluation of reflux operations depends on measurements of preop
erative and postoperative clinical symptoms such as dysphagia and heartburn
, assessment of quality of life and objective measurements of 24-hour oesop
hageal pH monitoring and manometry. Quality of life can be measured with qu
estionnaires such as the Gastrointestinal Symptom Rating Scale (GSRS), the
Psychological General Wellbeing Index (PGWB) and the Reflux-related Visual
Analogue Scale (RVAS). Failure of treatment is indicated by persistent symp
toms such as heartburn, need for antisecretory medication, and new symptoms
such as severe dysphagia. The advantages of laparoscopic operations are ma
inly a quick recovery and a good cosmetic results. Good short-term cure of
symptoms is reported in 90%-97% of patients who have laparoscopic fundoplic
ation. The long-term clinical outcome is equal to or better than that of op
en operations. Several clinical studies have shown that laparoscopic fundop
lication is effective in improving symptom ratings and the quality of life.