Laparoscopic fundoplication for minimal esophageal damage is feasible and reasonable in selected patients. This approach seems to be as safe as an open procedure; however, a period of learning is required to achieve maximum benefit. As experience is gained, the operative time, hospitalization time, conversion rate, and functional results improve. If one examines the change in quality of life before and after laparoscopic fundoplication, the full extent and significance of patient-related benefits still remain undefined. Length of follow-up has yet to reach the level of that reported for open procedures. Continued evaluation and follow-up are necessary to assess the long-term effectiveness of laparoscopic Nissen fundoplication.
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