How I Do It: Surgical Implantation of the RefluxStop™ Device for Gastroesophageal Reflux Disease

The RefluxStop procedure reconstructs the antireflux barrier (ARB) while avoiding sequelae of encircling/compressing the distal esophagus. It has become the primary antireflux procedure at our institutions with few side effects and improved treatment effect based on our experience, including in ineffective esophageal motility (IEM) and large hernia sufferers. Key steps include extensive esophageal dissection superiorly and posterior dissection of the fundus to create a floppy fundus, looser crural repair, 90° to 120° left-sided esophagogastric plication between the vagal trunks, and loose device fundal pouch invagination 5 cm above the angle of His, to stabilize the ARB and gastroesophageal junction.