Gastroesophageal reflux disease(GERD)is a common digestive disorder with a global prevalence of approximately 13%.The primary surgical options include the 360° Nissen fundoplication,270° Toupet fundoplication,and 180° Dor fundoplication.While the Nissen procedure demonstrates superior long-term outcomes compared to the other methods,it is associated with a higher incidence of postoperative dysphagia.Surgical decisions should be individualized based on esophageal motility and pH monitoring.The surgery not only aims to repair anatomical structures,but also to restore function,including the length of the abdominal esophagus and the angulation between the crura diaphragm and the spine.Reconstruction of the gastroesophageal valve and the phrenoesophageal fascia is crucial for optimizing surgical outcomes and preventing postoperative complications.Given the physiological and psychological changes associated with GERD,personalized treatment is essential for improving symptoms and enhancing quality of life.

Objective:To explore the efficacy and safety of laparoscopic Dor fundoplication in treating gastroesophageal reflux disease (GERD) after laparoscopic sleeve gastrectomy (LSG).Methods:A retrospective analysis was conducted on 11 patients undergoing laparoscopic Dor fundoplication between Oct 2021 and Oct 2023. These patients had previously undergone LSG due to obesity and related metabolic diseases and developed GERD postoperatively. The GerdQ scale scores, results of endoscopy, upper gastrointestinal radiography, and gastric window color Doppler ultrasonography were analyzed.Result:Surgeries were successfully performed in these 11 patients. After esophageal hiatus repair, 10 patients underwent reinforcement of the diaphragmatic crus using biological or synthetic anti-adhesion patches. The average operative time was (120±31) minutes, and the average postoperative hospital stay was (9±3) days. Follow-up at 6 months revealed complete resolution of GERD symptoms in 10 patients. Intraoperatively one patient sustained injuries to the left hepatic vein and esophagus. Postoperative complications included one case of intestinal obstruction and one case of dysphagia, one patient failed to get experience improvement in GERD symptoms. All complications were managed successfully except for one needing re-admission for interventional esophageal balloon dilation due to dysphagia.Conclusion:Laparoscopic Dor fundoplication serves as a safe and effective revision surgery for GERD following LSG.