Everyone’s esophageal physiology is different. I needed the Toupet due to uncontrolled GERD, that worked, I had a second surgery to take down the Toupet to a Dor in the hope that would help my dysphagia. It did not. After having gone through that, plus two more dilations, the conclusion is that my problem is not structural but a functional problem with ineffective motility. It’s taken weeks to get a referral but I am seeing a motility specialist next week. Don’t give up on the Toupet if you need it, especially if you have Barrett’s like me. But I would make sure that is your only realistic option. There is a new class of drugs the FDA just approved for esophagitis called P-CABs that might help in the future for folks that can’t tolerate the adverse effects of PPIs, like me. I learned through this yearlong process that surgeons think like surgeons, so make sure your general GI is on board. Cheers