A Toupet or “Partial” Fundoplication is a very effective mechanism for controlling reflux. We choose to offer this type of repair when we are suspicious that the patient has a problem with their swallowing mechanism in addition to their classic reflux issues This type of repair does not apply quite as much pressure or compression on the lower esophagus as a standard Nissen fundoplication. If the Nissen procedure is a 360 degree wrapping of the stomach around the lower esophagus the Toupet is a 270 degree wrap. As we explain it to our patients is similar to releasing the top button on a tight pair of pants after a big meal. Your pants stay up but you are much more comfortable.