The Toupet operation (270 degrees posterior fundoplication) has been performed in 99 patients suffering from symptoms of gastro-oesophageal reflux secondary to a hiatal hernia. To assess the effects of the Toupet antireflux procedure, we performed in 20 cases oesophageal manometry, intraoperatively and gastro-oesophageal scintiscan in the early postoperative period (3 months: 98 cases) and also later (5 years). For us gastro-oesophageal scintiscan is the ideal method of detecting reflux because it is a noninvasive technique as sensitive as the intra-oesophageal pH, is easy to perform and well-tolerated by the patient. Our long-term follow-up, with only 6% of poor results show that the Toupet operation like the Nissen fundoplication is the most effective surgical technique that can be used to correct gastro-oesophageal reflux and has an added advantage: the side effects, particularly the postfundoplication or gas-bloat syndrome are minimal. Additional follow-up after 10 years will be needed to establish the final outcome of the operation.