While fundoplication as a treatment for gastroesophageal reflux disease (GERD) has been largely successful, the rise in reflux cases refractory to initial surgery presents a unique challenge in the search for more durable symptom relief. In addition to principles pertaining to medical management and reoperation, this article discusses several nuances to consider in the careful evaluation of recalcitrant GERD post-fundoplication to optimize long-term success after revisional antireflux surgery from a surgical perspective.
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