Complications Following Fundoplication

Laparoscopic fundoplication has become a widely used therapy for gastroesophageal reflux disease (GERD). Although safe and effective in most patients, some patients will report persistent, recurrent, or new symptoms following fundoplication. These symptoms, as well as recurrent reflux symptoms, can develop due to recognizable technical or surgical complications, including disruption or herniation of the fundoplication. In addition, they may develop without obvious technical problems with the fundoplication. Common symptoms include dysphagia, gas-bloat syndrome, and diarrhea. Successful management requires an understanding of the possible causes of postoperative symptoms and problems and a systematic evaluation of the patient. This article provides a framework and approach for evaluating and managing problems and complications after fundoplication for GERD.