Current status and trends in laparoscopic antireflux surgery: results of a consensus meeting. The European Study Group for Antireflux Surgery (ESGARS)

Abstract

Laparoscopic surgery for gastroesophageal reflux disease has replaced the open approach in several institutions, and it is likely to become the "standard" for treatment in the near future. Members of five European surgical centers with extensive experience in pathophysiological research, diagnostic testing, and conventional surgery for esophageal disease met after five years of experience in using laparoscopic antireflux surgery, and established a plan to evaluate the potential for consensus among the centers involved in the surgical management of the disease. The consensus process started with a pathophysiological assessment of the reporting requirements for diagnostic workup. To allow a thorough appreciation of the surgical techniques used by all the participants, experience was exchanged in collaborative operations in an experimental surgical laboratory. It was concluded that the pathophysiological background to the disease is multifactorial, as many publications have shown in recent years. The group's meetings and discussions established a consensus list for the preoperative assessment of patients suspected of having gastroesophageal reflux disease, as well as a common list of operative techniques for successful antireflux surgery.