Its relative safety and efficacy are controversial, with the American College of Gastroenterology recommending against its use in 2013, and in the same year the Society of American Gastrointestinal and Endoscopic Surgeons ( SAGES ) giving it a strong recommendation for people who refuse laparascopic Nissen fundoplication, which involves making incisions in the torso and wrapping part of the stomach around the base of the esophagus, and which is considered the gold standard for efficacy.
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