NISSEN FUNDOPLICATION - A special surgical procedure known as Nissen fundoplication is useful in those patients who fail medical management for the treatment of reflux esophagitis. By manipulating the lower esophagus and stomach, a zone of increased pressure is created in the lower esophagus. The increase in intraluminal pressure will discourage the reflux of stomach acid back into the esophagus (which can lead to esophageal inflammation). There are several variations of this procedure, but some surgeons are now offering this operation laparoscopically.