The Nissen fundoplication remains the most durable and effective anti-reflux operation. There have been many modifications since it was first introduced. The most notable modifications include a minimally invasive approach, which significantly decreases the morbidity of the operation and technical changes which decrease the risk of potential side effects. The Nissen fundoplication is still associated with the side effects of gas bloat, the inability to belch and vomit, and the occurrence of persistent dysphagia. However, identifying the correct surgical patient, meticulous technique and post-operative care help improved outcomes and the success of the operation.
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