Indroduction: The continuous innovations in the medical field and the advent of minimally invasive surgery they have changed substantially in the marl-bed surgical treatment of upper gastrointestinal diseases. A better understanding of the pathophysiology of GERD and the advent of minimally invasive surgery have laid the foundations to find the ideal antireflux. Purpose of this study is through the evaluation of our results identify the parameters that constitute the foundations of this plastic ideal antireflux. Materials and methods As of January 2005 to December 2013 at the II Clinical Surgery and digestive surgery department of general surgery and specialized company polyclinic II University of Catania underwent a functional study to the intervention of plastic anti[1]reflux for GERD n 66 patients (27 males, n 39 women aged between 42-57 years, mean age 49.5) the total or partial plastic choice was due to the clinical picture of the results the total or partial plastic Choice was due to the clinical picture .In the presence of severe dyskinesia proportional to the degree of esophagitis it is a total plastic been implemented necessary. The dyskinesia with distal esophageal amplitude of less than 40mmHg is a partial antireflux plastic was implemented. Discussion In the presence of GERD not obstructive The distinction of patients with and without disfagia is not possible because there is no difference of esophageal motor framework, and a differentiation occurs during meals for the presence of continuous waves not propelling the distal esophagus Singh medical antisecretory therapy is not able to block the progression from metaplasia to dysplasia in patients with Barett. The asserts an increased risk of 8 times in patients in which the regurgitation, and heartburn occurring once a week is. Therefore logical to assume in light of the results obtained as a blocking GERD through effective antireflux it prevents more serious illness. Conclusions In GERD fundoplication arises as a necessary and effective for the purpose of blocking the natural history of the disease through an antireflux
