“…Despite their widespread use, PPIs are associated with complications that include gastrointestinal infection, hypocalcemia, hypomagnesemia, osteoporosis, and an increased risk of bone fracture [2]. However, some patients are refractory or resistant to medical treatment and require surgical management [3,4]. The most common indications for surgical treatment of GERD include lack of response to medical treatment, erosive GERD, Barrett esophagus, hiatus hernia, and severe symptoms of GERD, particularly at night time.…”