Redo antireflux surgery

Laparoscopic antireflux surgery (ARS) has become the gold standard for medically refractory gastroesophageal reflux disease (GERD]. Though primary ARS has excellent safety and outcomes, up to 10% of patients undergoing laparoscopic fundoplication will eventually require reoperative antireflux surgery (redo-ARS). Laparoscopic redo-ARS is notoriously difficult with higher complication rates and worse outcomes when compared to the primary operation, and requires a thorough understanding of the surgical options and a high level of surgical skills. It is crucial for the surgeon and the patient to come to an agreement on postoperative expectations prior to embarking with revisional surgery, with a clear understanding that outcomes are generally worse after redo-ARS. Despite the technical challenges redo-ARS presents, when performed at a high-volume center, more than 80% of patients report satisfaction with their revision.