The modern history of surgery for gastroesophageal reflux (GER) is rich. Since the 1930s, GER has been associated with hiatal hernia. The first operations were designed to correct the anatomic abnormalities by reducing the hernia and closing the crura. This led to a 50% recurrence rate of reflux symptoms, so these procedures were abandoned.<sup>1 Allison P.R. Reflux esophagitis, sliding hiatus hernia and the anatomy of repair Surg Gynecol Obstet 1951 ;  92 : 419-431

Cliccare qui per andare alla sezione Riferimenti</sup> Nissen first used a gastric fundoplication in 1936 to protect the anastomosis after distal esophagectomy in a patient with a deeply penetrating esophageal ulcer.<sup>34 Nissen R. Die transpleurael resektion der kardia Dtsch Chir 1937 ;  249 : 311-316  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Endoscopy 16 years later revealed no esophagitis. He performed his first fundoplication for GER in 1955, a 360-degree 6-cm fundic wrap around the distal esophagus.<sup>35 Nissen R. Eine einfache operation zur beeinflussung der refluxoesophagitis Schweiz Med Wochenschr 1956 ;  86 : 590-592

Cliccare qui per andare alla sezione Riferimenti</sup> Belsey published his first series of the Belsey Mark IV transthoracic fundoplication 5 years later with very good results.<sup>21 Hiebert C.A., Belsey R. Incompetency of the gastric cardia without radiologic evidence of hiatal hernia J Thorac Cardiovasc Surg 1961 ;  53 : 33

Cliccare qui per andare alla sezione Riferimenti</sup> In 1965 Nissen and Rosetti published a report of an anterior fundal wrap of the esophagus to be used in extremely obese patients.<sup>36 Nissen R., Rossetti M. Surgery of hiatal and other diaphragmatic hernias J Int Coll Surg 1965 ;  43 : 663-674

Cliccare qui per andare alla sezione Riferimenti</sup> Rosetti and Hell developed a 360-degree fundoplication without taking down the short gastric vessels.<sup>9 Collis J.L. An operation for hiatal hernia with short esophagus J Thorac Cardiovasc Surg 1957 ;  34 : 768

Cliccare qui per andare alla sezione Riferimenti</sup> In 1985 Donahue published the advantages of using the “floppy” fundoplication to help avoid the gas bloat syndrome <sup>12 Donahue P.E., Samuelson S., Nyhus L.M., Bombeck C.T. The floppy Nissen fundoplication: Effective long term control of pathologic reflux Arch Surg 1985 ;  120 : 663-667

Cliccare qui per andare alla sezione Riferimenti</sup> and in 1986 DeMeester described a fundoplication technique with only 1 to 2 cm of the fundus around the distal esophagus to help prevent gas bloat and dysphagia.<sup>11 DeMeester T.R., Bonavina L., Albertucci M. Nissen fundoplication for gastroesophageal reflux disease: Evaluation of primary repair in 100 consecutive patients Ann Surg 1986 ;  204 : 9-20  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Other modifications have included narrowing the esophageal hiatus and several other partial fundoplications, as proposed by Dor in 1962, <sup>13 Dor J., Humbert P., Dor V., Figarella J. L'interet de la technique de Nissen modifiee la prevention du reflux apres cardiomyotomie extra muqueuse de Heller Mem Acad Chir 1962 ;  88 : 877-883

Cliccare qui per andare alla sezione Riferimenti</sup> Toupet in 1963, <sup>44 Toupet A. Technique d'oesophagogastropastie a el phrenogastropexie appliquee dans la cure radicale des hernia hiatal es et comme complement del'operation de Heller dans les cardiospamsus Mem Acad Clin 1963 ;  89 : 374-379

Cliccare qui per andare alla sezione Riferimenti</sup> Watson in 1991, <sup>47 Watson A., Jenkinson L.R., Ball C.S. , e al. A more physiologic alternative to total fundoplication for the surgical correction of resistant gatroesophageal reflux Br J Surg 1991 ;  78 : 1088-1094  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> and the Collis Nissen procedure for shortened esophagus in 1957.<sup>14 Ellis F.H. The Nissen fundoplication Ann Thorac Surg 1992 ;  54 : 1231-1235  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup>

The easiest fundoplication to perform and teach, as well as the most common operation performed in the United States, is the Nissen procedure, and this was the first to be performed laparoscopically in 1991.<sup>19 Geagea T. Laparoscopic Nissen fundoplication: Preliminary report on ten cases Surg Endosc 1991 ;  5 (4) : 170-173  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Since then there have been several large series of laparoscopic fundoplication showing safety, efficacy, good quality of life, short hospital stay, and early return to work. As well, a cost savings over open surgery has been demonstrated in some series.<sup>10 Coster D.D., Bower W.H., Wilson V.T. , e al. Laparoscopic Nissen fundoplication—a curative, safe, cost-effective procedure for complicated gastroesophageal reflux disease Surg Laparosc Endosc 1995 ;  5 (2) : 111-117

Cliccare qui per andare alla sezione Riferimenti, 30 Laycock W.S., Oddsdottir M., Franco A. , e al. Laparoscopic Nissen fundoplication is less expensive than open Belsey Mark IV Surg Endosc 1995 ;  9 : 426-429

Cliccare qui per andare alla sezione Riferimenti</sup> The long-term results of laparoscopic fundoplication will not be known for another 5 to 10 years.