Floppy Nissen.

I think is a better and sure option maintenance treatment with IBPs and loosing weight

Well, the partial fundopexy might be appropriate for adults. In my practice I have applied the Toupes method to 5 children with good early results, except in the first one, and in the late follow-up I found in other 3 children recurrence of the reflux disease because of wrap disruption. This is most likely due to the disproportionate development of the damaged esophagus and the stomach during the rapid child’s growth. Regarding the surgical technique, I always apply the classical suturing of the stomach fundus to the diaphragm in order to strengthen the angel of Hiss.

Always will be better to choose partial fundoplication , with great efficacy and less side-effects

It depends on the degree of pre operative dysphagia and Oesophageal dysmotility. My feeling is that a Nissen provides greater long term control of reflux.

Of course the evidence for tailoring of wraps is limited but personally I prefer a floppy Nissen for most cases (dividing the SGs helps to achieve this) unless the patient has significant dysphagia, dysmotility, or a large para Oesophageal hernia in which instances I would do a partial anterior dor fundoplication.

I am also favorite for performing a non-total Nissen closure of the hiatus