Those people who have continuing symptoms despite lifestyle modification and the prescribed use of appropriate medication as well with those with complicated disease should consider an operation to cure their GERD. The most common operation performed, called a fundoplication, involves wrapping the top of the stomach around the esophagus. This is done as either a “Full Wrap” or a “Partial Wrap”. A Full Wrap creates what looks like a “napkin ring” around the lower esophagus whereas a Partial Wrap gives the appearance of a “hot dog in a bun”. The fundoplication creates a higher LES pressure. It does not have to be tight to do this. For almost all people having this operation heartburn ends immediately. Most people do have some degree of difficulty swallowing afterwards. Patients who undergo a Partial Wrap tend to have less difficulty swallowing than patients who undergo a Full Wrap. The relieve of reflux symptoms is equivalent in both groups. All of these procedures are performed laparoscopically today. Patients undergo general anesthesia and are fully asleep. The operations typically last about 1 and 1/2hours. Our patients are usually in the hospital 1 –2 days after surgery. Like patients having laparoscopic gallbladder operations, these patients are back to their usual activity in less than a week. Remote risks of the operation are injury to the spleen, liver, esophagus, or stomach, which might result in bleeding or infection. Those injuries are very uncommon and usually correctable. There is also the risk that the operation might not completely eliminate GERD, that swallowing difficulties might be prolonged, or that you may have some transient difficulty vomiting. A Partial Wrapis performed in the majority of cases; however, selected patients sometimes will require a Full Wrap. Dr. Lydon and his associates havebeen performing laparoscopic fundoplications since 1992 and wereinvolved in the first procedures done in the region. Therate of conversionfrom a laparoscopic procedureto an“open” procedure is well under1%. Approximately 85% of patients are able to completely stop their acid reducing medication post op.