Reoperative antireflux surgery.

Antireflux surgery is a successful procedure in the treatment of severe gastroesophageal reflux disease. During this procedure, if the following four elements are observed, (1) adequate mobilization of the distal esophagus into the abdomen without tension, (2) construction of an appropriate fundoplication, (3) closure of the diaphragmatic crura, and (4) anchoring of the esophagogastric junction and fundoplication in the abdomen, the patient can be expected to achieve an excellent outcome from either a primary or a secondary antireflux operation.