How is laparoscopic fundoplication done?

• The mid abdomen is punctured at five points to facilitate the entry of the endoscope with a camera and other laparoscopic surgery tools. Carbon dioxide gas is insufflated into the abdominal cavity to provide better view and room for operation.
• A flexible rubber tube is passed down the oesophagus and sutured to tighten the large opening in the diaphragm around the oesophagus.
•  The top portion of the stomach is then wrapped around the back of the oesophagus and its portion which is now on the right side of the oesophagus is sutured to the portion on the left to keep the wrap in place.
• A flexible rubber tube (bougie) is passed down the oesophagus to prevent the wrap from being too tight.