Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 4: How Important Is Surgeon Selection In Antireflux Surgery? Is The Laparoscopic Approach Now Standard Of Care For A Nissen Fundoplication? (continued)

The decision to undergo antireflux surgery is complex. Medical therapy in and of itself if successful is an excellent long-term option with documented long-term success, usually at a stable dose of medication, with little to no long-term risk. Although there have been recent concerns about the possibility of enteric infections, pneumonia, and most recently hip fractures in patients taking long-term proton pump inhibitors, in general I do not believe any of these are reasons to consider surgery. Because there are potential complications of an elective operation, I believe that surgical…