[Laparoscopic fundoplication--what is proven?].

Laparoscopic fundoplication has become a popular procedure but several questions remain unresolved. Although randomised trials suggest that antireflux surgery is a good alternative to continuous medical therapy, the selection of patients for surgery remains crucial to achieve success. There is currently no proof that antireflux surgery will reduce the risk for developing esophageal adenocarcinoma. Complications, side effects and failures appear to be higher after a laparoscopic approach as compared to conventional open surgery, particularly in un-experienced hands. Partial fundoplications and tailored approaches have so far not shown convincingly better results than those that can be achieved by short and floppy 360 fundoplication.