The place of minimal access surgery amongst people with gastro-oesophageal reflux disease (GORD) - a UK collaborative study

1. To evaluate the clinical effectiveness, cost-effectiveness, and safety of a policy of relatively early laparoscopic surgery compared with continued medical management amongst people with GORD judged suitable for both policies. 2. To explore factors which may influence the relative performance of the two policies, such as patient preference, surgeon experience, pre-enrolment symptoms and signs, the underlying pathology, the type of operative procedure used or choice of therapy, and the time since surgery. 3. To explore the impact that various policies for using laparoscopic surgery would have on the NHS and society in respect of the costs or savings that they would imply for (a) those providing surgical care (in secondary care settings), (b) those providing long-term medical management (usually in primary care settings), and © those with GORD.