This video illustrates an updated version of the Hill Laparoscopic Antireflux Procedure. In collaboration with Snow of Alabama and Larrain of Santiago, Chile, 134 cases have been done with a two-year follow-up. This represents the largest series of laparoscopic antireflux operations to be reported. The technique includes calibration of the lower esophageal sphincter, restoration of the gastroesophageal valve, anchoring of the gastroesophageal junction posteriorly to restore esophageal clearance, and closure of the diaphragm. Extensive pre-and postoperative studies show that the lower esophageal sphincter pressure has been restored to normal in 74 patients tested postoperatively. Endoscopy with retroflexed view of the valve shows restrotation of a grade 1 or normal gastroesophageal valve in all cases.