In simple words: The surgeon makes an incision in the chest to access the esophagus and stomach. They then wrap the top part of the stomach around the lower esophagus to create a tighter valve, preventing stomach acid from flowing back up into the esophagus. This procedure is done to treat severe heartburn or acid reflux.

This procedure involves wrapping the upper part of the stomach (fundus) around the lower esophagus to treat gastroesophageal reflux disease (GERD). It is performed through an incision in the chest. The surgeon may dilate the esophagus using a bougie and then secures the stomach around the esophagus with sutures. The wrap can be partial or complete, depending on the patient's condition.The procedure addresses the underlying anatomical issue causing GERD.

Example 1: A 55-year-old patient with chronic GERD, unresponsive to medication, undergoes a complete fundoplication via thoracotomy (43328) due to a large hiatal hernia, which requires the transthoracic approach., A 30-year-old patient with a history of failed laparoscopic fundoplication presents with recurrent GERD symptoms. A redo fundoplication via thoracotomy (43328) is performed due to extensive adhesions from the previous surgery, precluding a laparoscopic approach., A 60-year-old patient with a complex paraesophageal hernia and severe GERD symptoms undergoes a partial fundoplication via thoracotomy (43328) due to the complexity of the hernia and the need for a more extensive surgical approach.

Operative report detailing thoracotomy, extent of fundoplication (partial or complete), any intraoperative findings (e.g., hiatal hernia size, adhesions), and confirmation of the creation of a new valve mechanism. Preoperative studies, including esophagogastroduodenoscopy (EGD) and esophageal manometry, should be documented. The medical necessity of the procedure should be clearly justified based on the patient's symptoms, failed medical management, and anatomical findings.