Laparoscopic Thal Fundoplication

The Thal fundoplication is a 180–270° anterior wrap. The basic dissection is similar to that of any other fundoplication, except that it does not require a posterior window or posterior mobilisation of the oesophagus and requires less dissection of the crus. It achieves the same surgical objectives as other types of fundoplication, i.e., ensuring an intra-abdominal oesophagus, creating an acute angle at the gastro-oesophageal junction, and creating a high-pressure zone around the lower oesophagus [1]. Thal fundoplication has an equivalent success rate in neurologically normal children but has a higher failure rate in neurologically impaired children when compared with the Nissen fundoplication. It also results in less postoperative dysphagia [2].