Laparoscopic approaches to gastroesophageal reflux disease

While there are only a few early reports available, it appears certain that minimally invasive techniques will play a role in the treatment of gastroesophageal reflux. However, the laparoscopic surgeon should be forewarned that the skills acquired for laparoscopic cholecystectomy are not particularly applicable to fundoplication. Before abandoning the traditional open approach, it is wise to develop sound intracorporeal suturing skills in an appropriate animal model. A healthy dose of skepticism is also in order until we can adequately demonstrate results equivalent to historical controls.