According to the results of many surgical series and only two randomized head‐to‐head comparisons, fundoplication and antisecretory medication appear, at least in the short term, to be equally effective in the management of GERD. I haven't thrown up in 25 years, just been incredibly nauseas and had dry heaves so I'm not sure the not being able to vomit part will effect me too much. A novel endoluminal fundoplication (ELF) technique using a trans-oral and fastener-deploying device (EsophyX, EndoGastric Solutions) was developed and evaluated for feasibility, safety and the treatment of gastroesophageal reflux disease (GERD) in a series of bench, animal, human (phase 1, phase 2, commercial registry) studies. The authors concluded that there was no significant difference in the numbers of cancers per patient years between patients treated with surgery (3.8/1000) or medical therapy (4.3/1000) in the last 5 years.17. Fundoplication is associated with a host of potential complications and side‐effects. It was around 20,000 I was in the hospital 3 days. The operation is technically complex and takes a long time to learn. The long‐term success of fundoplication remains in doubt, as the wrap tends to become loose over a prolonged time period, with many surgical patients continuing to take antisecretory medication after fundoplication. It has been suggested that even the investment of screening endoscopy, which is far less risky and costly than fundoplication, is difficult to justify for the prevention of such a rare disease as acid‐related oesophageal adenocarcinoma.18, 19. They fail to provide complete relief of reflux symptoms and do not heal erosive oesophagitis. The cancer rate after surgery was one cancer per 294 patient years, compared with one cancer per 145 patient years after acid inhibition. I thought I was having an off day...LOL. BACKGROUND: Several devices have been developed to create an antireflux barrier endoscopically for the treatment of gastroesophageal reflux disease. Laparoscopic fundoplication failures. Best of luck. In a cost analysis accompanying the randomized clinical trial of fundoplication vs. medical therapy, Myrvold and coworkers compared the 5‐year cumulative expenditures per patient in each treatment arm.9, 28 As the study was conducted as a multicentre trial in various Scandinavian countries, the cost comparisons also pertained to different countries. As in the previous cost analysis, the cost‐effectiveness ratio in favour of medical therapy decreased as the length of time after surgery increased and the initial expense of surgical treatment was redeemed. Copyright © 2015 Elsevier Inc. All rights reserved. The TIF procedure differs from a traditional fundoplication procedure because it is performed through the mouth rather than through laparoscopy or open abdominal incisions. However, the direct medical costs remained significantly lower for medical therapy than for surgical therapy in Denmark, Norway and Sweden. Fundoplication has been claimed to reverse the underlying motor dysfunction of reflux disease and prevent the gastro‐oesophageal flow, not only of hydrochloric acid, but also of bile and other gastroduodenal contents. In the short term, fundoplication and antisecretory medication are equally effective in the management of gastro‐oesophageal reflux disease. It should also be noted that protection against the occurrence of Barrett's oesophagus is impossible to prove without an appropriate control group. How safe and effective is endoscopic full-thickness plication for the treatment of patients with GERD?. THAT’s RIGHT! Radiofrequency energy delivery has been in use for more than a decade and has been proven to reduce GERD symptoms and PPI use. I have been sick stomache cramps, and diahrea so often I have dehydrated twice. As an alternative to surgical fundoplication, gastroenterologists have developed an endoscopic suturing device to place placating stitches in the region of the gastro‐oesophageal junction.33 With the presently available instrument (from Bard Interventional Products Billerica MA, USA), placement of the sutures is a time consuming and difficult procedure. Comparison of fundoplication and omeprazole maintenance therapy with respect to their cost‐effectiveness and its dependence on the operative cost as well as the length of follow‐up.27.