Laparoscopic antireflux surgery for reflux esophagitis.

Proton pump inhibitors (PPIs) are recommended as first-line therapy for reflux esophagitis. Recent studies documented that more than 25 % of patients have some symptoms of GERD despite PPI therapy. In 2015, a newly developed acid inhibitor, potassium-competitive acid blocker(P-CAB), were started marketing. P-CAB, PPIs, and H2 blockers are antisecretory drugs of gastric acid, and no medicine can reduce gastroesophageal reflux(GER). The cause of GER is the insufficiency of antireflux mechanism of the cardia. Only surgical treatment can repair these situations. Most frequent antireflux procedures for GERD are Nissen and Tou- pet fundoplications. As for postoperative dysphagia, our first choice is laparoscopic Toupet fundoplication (LTF). We herein report our technique of LTF.