Inclusion Criteria:  Patients with typical symptoms of GERD with symptomatic response to PPI therapy for ≥ 3 months Patients considered for non-medical therapy, i.e. unwillingness to take life-long medication in medically-responding disease, suffering from medication side-effects or medically-intractable disease Pathological esophageal acid exposure after discontinuation of medical therapy, proven by ambulatory 24-hour pH-monitoring with > 5% of time a pH < 4 and a symptom-association probability > 95% written informed consent  Exclusion Criteria:  24 hr acid exposure study showing abnormal esophageal acid exposure <4% DeMeester Score <14.7 hiatal hernia (> 3 cm in length) history of antireflux or esophageal/gastric surgery severe psychiatric disease Barrett's esophagus with dysplasia esophageal stenosis/malignancy pregnancy or lactation history of low therapeutic compliance other severe comorbidity (including cardiopulmonary disease, portal hypertension, collagen diseases, morbid obesity, coagulation disorder) use of anticoagulant or immunosuppressive drugs