Surgical Treatment of Gastro-Oesophageal Reflux Disease (GERD): A Brief Review

Review Article

Abstract

Gastro-oesophageal reflux disease (GERD) affects up to 20 % of the Western population, causing heartburn, acid regurgitation and complications such as erosive oesophagitis and Barrett’s oesophagus. Although proton-pump inhibitors (PPIs) control symptoms in most patients, about 30 % remain symptomatic or develop complications, making surgery indispensable in selected cases. Laparoscopic fundoplication total (Nissen) or partial (Toupet, Dor) is the gold standard, with high clinical success, normalisation of oesophageal pH and a marked improvement in quality of life. Compared with the open approach, laparoscopy reduces postoperative pain, length of stay and morbidity, but demands careful assessment of oesophageal motility and hiatal hernia. Complications such as transient dysphagia, gas-bloat syndrome and reflux recurrence occur in up to 15 % of cases and are minimised by experienced teams and well-established protocols. Cost-effectiveness analyses show long-term savings owing to reduced lifelong PPI use and fewer admissions. Robotic surgery has produced promising results in precision and ergonomics, although its widespread adoption is limited by high costs and restricted availability. Properly indicated and executed by a multidisciplinary team, surgical treatment provides durable symptom relief, prevents severe complications and improves quality of life in GERD.