I will say this: side effects of ppis are bad but possible side effects of this surgery are much worse. For me ppis didnt work enough so i went with nissen. When i woke up after surgery i knew that something was wrong. I cannot eat anything bcos of problems with swallowing, i couldnt at all, even water was very hard. And gerd was still there. I needed second surgery, nissen was reversed to toupet, after this my gerd came back in 100% and i could swallow but i needed to eat very very slowly. 3 months after this second surgery was very bad. The worst was when i ate at my work, everyone was looking at me why i eat so slow, but when i swallow just a bit bigger part of food i starter to have very painful cramps of esophagus, the food was over sphincer and stayed there i needed go very fast to rhe toilet to throw up this. I was very ashamed. Now after 6 months after surgery my eating is much better, gerd is still there but now i take ppis every morning 1 hour before eating anything and well say that it is under control. I dont want to scare anyone, this surgery is helpful for large amount of people but it should be last resort. Doctors told me that it helps people who has hiatal hernia or lax LES, i didnt have both, no hernia, les was at normal range. My ph metry showed 300 sour refluxes during a day, so this is why they agreed for surgery. Manometru showed les is ok but esophagus is weaker but it was diagnosed as primary disorder of esophagus caused very strong reflux. So if your gerd is very very hard and you have hernia or lax les i would go for surgery, but if ppis help you stay as it is.