الفهرس 
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Abstract
Background: Gastroesophageal reflux disease is increasingly prevalent and costly, and it may affect as much as 20% of the western population. The aspect of the standard Nissen fundoplication –dividing the short gastric vessels- can be quite challenging, although the introduction of the laparoscopic coagulating shears, or harmonic scalpel, has facilitated this process. Some surgeons argue that division of the short gastric vessels is not needed to create a loose fundoplication, others claim that not doing so can lead to a more restrictive wrap and thus increased postoperative dysphagia The laparoscopic Nissen’s fundoplication procedure provided an excellent solution for this problem and has been standing against time since the development of this procedure. A wide range of modifications were offered to improve the efficacy and decrease the morbidity of this operation, one of them was the Rossetti-Hell modification; a highly debatable approach once put in comparison with the original procedure.
Aim of the Work: To compare prospectively the incidence and the possible causes of dysphagia after the performance of laparoscopic Nissen and Modified Rossetti-Hill technique.
Patients and Methods: This was a prospective randomized study that was conducted on twenty (20) patients presenting to Ain-Shams University hospitals in whom fundoplication is indicated for management of chronic GERD and was operated from August 2017 to September 2018 with minimal follow up duration of one year.
Results: In our study 20 patients were randomly divided into 2 groups and each group underwent one of the two fore-mentioned procedures, and we compared multiple aspects as regard these procedures to clarify and stand on the significance and the sequelae of short gastric vessels division in the procedure of fundoplication, where the patients were subjectively and objectively followed up for 3-6 months post-operatively; which is considered a relatively short period but of valuable and predictive evidence for the long term.
Conclusion: The Rossetti procedure carried better results in the operative time and operative bleeding though it showed nearly no difference in incidence of post-operative dysphagia. Thus weighing the risk-benefit leads us to conclude that; the Rossetti’s modification is a safer, time sparing and efficient alternative for GERD patients who require surgery for the optimum control of their disease.