An older surgery for reflux is called a Roux en Y gastric bypass. Although now famous for its use as a weight loss surgery, it has a long history of being a very effective reflux operation.

This operation works by separating the esophagus and the upper part of the stomach from the lower portion of the stomach.  Since most of the acid and digestive enzymes are in the lower stomach portion, none of this fluid can now reflux into the esophagus.  The food you eat is transported by a portion of small bowel to an area beyond the lower stomach.  The digestive enzymes are then routed to meet the food in your meal farther down the intestinal tract.
 
From a historical perspective, this surgery was usually performed as an open incision operation.  When the Nissan was developed as a laparoscopic surgery, it became the favored surgery because of the smaller incisions, shorter hospital stay, and decrease in complications of surgery such as wound infections and hernias.
 
The one weakness of the Nissan fundoplication is that it is less effective with heavier weight patients.  If there is enough abdominal girth, the weight of the abdominal wall may create a greater pressure on the stomach than the pressure caused by the wrap on the esophagus.  If there too much pressure, reflux still occurs.
 
In general, the Roux en y gastric bypass is still favored if your weight is more than about 75lbs over ideal weight, or if your Body Mass Index (BMI) is greater than 35 kg/m2.  For more information on weight and BMI, see www.wls-mib.com
 
The reason a Roux en y gastric bypass is more effective is that it does not rely on pressure differences to control reflux.  Instead, it diverts acid away from the areas that are being damaged.

Roux en y gastric bypass is now also performed as a laparoscopic surgery, with the same benefits of shorter hospital stay, fewer wound infections and fewer hernias.  In addition, it is a very effective surgery for inducing weight loss and controlling many of the other diseases that occur in the overweight population. 

For more information see www.wls-mib.com