The first step in managing esophageal reflux disease involves medical treament. Anti-acid medications can neutralize acid that refluxes into the esophagus and prevent damage to the eophagus. If these medications do not eliminate symptoms, surgery may be necessary. The primary surgical treatment of esophageal reflux is called esophageal fundoplication. Fundoplication can be performed through an upper midline incision, or using a laparoscopic procedure.