Review article
Progress in surgical treatment of reflux disease

In the last decade vigorous development of surgical techniques has resulted in multiple increase of the number of laparoscopical procedures instead of classical methods of GERD treatment. It was caused not only by well-known advantages of laparoscopy like quick recovery of patients and good cosmetic effects but generally good results of laparoscopy comparable with traditional methods too. In qualification of patients to surgical treatment the following features are taken into account: case history, lack of the effects of proton-pump inhibitor treatment, the presence of hiatus hernia in gastroscopy and in radiological picture. Surgical treatment consists of narrowing of diaphragmatic crura and performing in different ways total or partial plication of the stomach fundus around the oesophagus, in order to improve the function of oesophageal inferior sphincter and to reconstruct His angle. Prevailing methods are: total fundoplication by Nissen and partial posterior fundoplication by Toupet or Balsey.