Microvasive gastric stapler: the device, technique, and preclinical results.

Antireflux surgery was initiated in 1950 with the Allison repair, improved in the 1970s with the introduction of the partial and complete fundoplication, and performed laparoscopically in the 1990s. Today the challenge is to perform the procedure endoscopically. The physiology of the gastroesophageal barrier and the causes and consequences of its failure are discussed. The experimental development of an intraluminal transgastric valvuloplasty is discussed, and comments are made about the future role of endoscopic repairs.