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Attila Csendes, MD

Arch Surg. 2007;142(11):1110-1111.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I read with great interest the article by Granderath et al¹ concerning the impact of laparoscopic Nissen fundoplication with prosthetic hiatal closure on esophageal body motility. I have several questions and comments:

1. What was the length of the Barrett mucosa?
   
2. The size of the mesh that they used, according to Figure 2, is meaningless, in my personal opinion. It is so small that it is hard to believe any real beneficial effect would result. In the nonmesh group, some patients even needed 1 suture to close the hiatus.
   
3. I am surprised that the total length of the lower esophageal sphincter was only 20 mm in each group. In my large experience over 6000 manometric studies in patients with pathologic gastroesophageal reflux, a total length near or less than 20 mm is seen in no more than one-third of the patients.
   
4. The mean resting pressure of lower esophageal . . . [Full Text of this Article]