Between October 1992 and July 1994, 55 patients with gastrooesophagal reflux disease underwent laparoscopic 270 degrees posterior fundoplication. The technique used was exactly the same as for the conventional approach. There were no deaths but there were 2 peroperative complications requiring conversions to laparotomy: one oesophagal perforation and one pleural perforation. The mean operative time was 150 min, ranging from 90 to 240 min. The mean hospital stay was 2.5 days, ranging from 1 to 14 days. One patient had to be operated on the 15th postoperative day because of a dysphagia secondary to an oesophagal motility disorder. One other patient underwent a laparoscopic treatment of a bowel obstruction on 30th postoperative day. None patient had dysphagia for more than 1 month after laparoscopy. The mean postoperative follow-up was 10 months with a good clinical result in 90% of the patients at 6 months. Four of our 15 first patients complained of recurrence of reflux symptoms. These preliminary results indicate that laparoscopic Toupet procedure can be performed safely and with similar results as for the open approach if the surgeon is well trained.