Figure 8 - Toupet repair.

In the Toupet repair, the fundus is wrapped 270 degrees around the distal esophagus. Securing the fundoplication entails suturing the fundus on either side of the esophagus. Identification of the anterior vagal branch helps prevent incorporation into a suture. Suturing the lateral aspects of the wrap to the crural edges stabilizes the repair. (Source: Peters, JH, DeMeester, T (eds). Minimally Invasive Surgery of the Foregut. St Louis, MO: Quality Medical Publishing; 1994, with permission)