The laparoscopic fundoplication was first developed in the early 1990's. When it was first introduced, it was revolutionary. The standard open fundoplication at that time was being performed through a 10 inch incision in the middle of the abdomen making a large incision between the ribs or by making a large incision in between the ribs and accessing the esophagus through the chest. The open procedure was poorly tolerated. With the advent of laparoscopy, a well-tolerated anti-reflux procedure was first made available.