A modified fundoplication which preserves the ability to belch.

This report describes a transabdominal antireflux procedure which combines some of the features of the operations described by Nisse, Belsey, and Hill. From 1972 through 1976, 61 patients underwent a conventional Nissen fundoplication and 54 patients were operated according to the method described in this report. None of the patients who had a Nissen operation was able to belch freely; 15% had a "gas-bloat syndrome". Return of the ability to belch often signified partial or complete brakdown of the plication, which occurred in 11% of the cases. By contrast, all but one of the patients who had modified plication were able to belch freely; there has been only one instance of recurrent reflux.