The aim of the surgical therapy of reflux oesophagitis is prevention of reflux, and the treatment of the irreversible complications of reflux such as strictures. Recent developments in the treatment of reflux are concentrated on an earlier diagnosis of reflux and oesophagitis and prevention of complications. The discussion as to the best surgical treatment of reflux, has in the course of years suggested several types of operations: - Thoracic reconstruction of oesophageal hiatus according to Allison ( 1951). - Anterior gastropexy according to Boerema (1955). - Abdominal fundiplication according to Nissen (1959). - Trans-thoracic fundiplication (Mark IV) according to Belsey (1967). - Posterior gastropexy according to Hill (1967). The indications for operative treatment of reflux oesophagitis differ from one centre to another. Generally speaking only patients with reflux, and symptoms and signs of reflux oesophagitis are treated. The results of the surgical techniques mentioned above, vary considerably (De Meester et a!, 1974, Behar, 1979). They give little insight in the pathogenesis of the oesophageal inflammation which can occur in the presence of reflux. In the approach to this problem, one could be satisfied with the development of an effective antireflux operation, but perhaps it is more realistic first to study more in detail the fundamental causes of oesophagi tis. This then may offer arguments leading to a more rational indication and choice of operative treatment.