Present concept of the Belsey mark IV procedure in gastro-oesophageal reflux and hiatus hernia.

One hundred patients with gastro-oesophageal reflux and hiatus hernia were treated at the North Middlesex Hospital, Regional Cardiothoracic Centre, between 1968 and 1969. All patients received surgical treatment by the Belsey mark IV technique with no significant complications. The 9-10 year follow-up has shown a recurrence rate of 10 per cent. The majority of recurrences occurred within 2 years of the initial operation. Seven of these recurrences had excellent results after a second mark IV repair. The improved quality of life in the successful cases was dramatic. This series indicates that a left transthoracic mark IV type of repair is a safe and reliable procedure and gives excellent results with relief of symptoms.