Controversies in the treatment of gastroesophageal reflux and achalasia

Figure 1 The Nissen fundoplication involves a 360-degree wrap (arrows) of the gastric fundus around the distal esophagus.

Figure 2 With the Toupet fundoplication, the gastric fundus (arrows) is incompletely wrapped around the posterior, distal esophagus.

Figure 3 The goal of the Heller myotomy is full-thickness division of the muscular layers (arrows) of the distal esophagus. The myotomy should be long enough to ensure complete obliteration of the lower esophageal sphincter.

Figure 4 The Dor fundoplication is a 180-degree anterior folding of the gastric fundus over the distal esophagus.