What is the effect of a Toupet fundoplication in GERD management?

• A. It reduces reflux in all patients.
• B. It is used only for achalasia.
• C. It provides no anti-reflux benefit.
• D. It provides anti-reflux barrier while allowing some esophageal clearance; tailored to patient.

Answer: (D)

Toupet fundoplication is a partial (usually 270-degree) posterior wrap that creates an anti-reflux barrier at the gastroesophageal junction while preserving the esophagus’s ability to clear food. Because it is not a full 360-degree wrap, it reduces the risk of swallowing difficulties in patients with weaker esophageal motility, yet still helps prevent reflux. The approach is often tailored to the patient’s esophageal motility findings: in those with poor peristalsis or motility concerns, a partial wrap provides reflux control without overly constricting bolus transit. That combination—anti-reflux protection plus preservation of esophageal clearance—best describes the effect of a Toupet fundoplication. It is not universally effective in every patient, it is not used only for achalasia, and it does offer anti-reflux benefit, unlike the non-benefit option.