Background: Gastroesophageal reflux disease (GERD) can be successfully treated by laparoscopic fundoplication with a high success rate of approximately 90%. A minority of patients will require refundoplication. Methods: Seven recent studies on the long-term outcome of first LARS comprising a total of 955 patients and 14 recent studies on the outcome of redo fundoplication including more than 600 patients were summarized. Results: For first LARS, patient satisfaction ranged between 86% and 95% after a follow up of 4-5 years. Two studies mentioned their revision rates, which were 3% and 4.8%, respectively. The various studies on the outcome of redo fundoplication reported a conversion rate between 0-25% and in general a high success rate. The studies came to the conclusion that refundoplication is feasible with good outcome in most patients. The majority of authors suggest that refundoplication should be carried out at high volume centers with ample experience with LARS. Conclusions: This article reviews the causes of failed fundoplications, presentation and diagnosis and subsequently gives an overview on indication, technique and outcome of refundoplication. Refundoplication is a feasible option for patients in whom first LARS failed.
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