Personalized Surgery in Foregut Disease: Tailoring Treatment for GERD, Hiatal Hernia and Esophageal Disorders

Foregut surgery has undergone a remarkable transformation in recent decades, driven by technological innovation, refined diagnostic tools, and a deeper understanding of esophageal physiology and pathophysiology. Despite the development of minimally invasive and robotic techniques and the availability of novel endoluminal interventions, a standardized approach to foregut disorders such as gastroesophageal reflux disease (GERD), hiatal hernia, and esophageal motility abnormalities is often insufficient. These conditions display substantial heterogeneity in anatomical presentation, symptom profiles, and physiological findings, creating challenges for uniform surgical management. Recent studies have demonstrated variable outcomes depending on patient phenotypes and procedure selection, highlighting the importance of individualized assessment. Current evidence suggests that tailored decision-making can improve outcomes and reduce recurrence, yet consensus regarding stratification criteria and optimal algorithms remains limited. Bridging this gap will require integrating clinical, functional, and technological insights to refine patient-centered surgical strategies.

This Research Topic aims to advance understanding and application of personalized approaches in the surgical management of foregut diseases. It seeks to examine how individualized treatment decisions—based on motility results, anatomical variables, symptom burden, and long-term follow-up—can optimize patient satisfaction and functional recovery. Particular focus will be placed on delineating frameworks for patient selection, evaluating procedure-specific outcomes, and exploring novel therapeutic technologies such as magnetic sphincter augmentation, robotic systems, and artificial intelligence-driven decision-support tools. By fostering interdisciplinary collaboration among surgeons, gastroenterologists, and allied specialists, this initiative aims to expand the evidence base for precision surgery in upper gastrointestinal disease.

To gather further insights into the evolving field of personalized foregut surgery, we welcome contributions emphasizing both clinical research and technological innovation. We particularly encourage studies that address, but are not limited to, the following themes:

• Patient-specific algorithms for GERD and hiatal hernia management;
• Tailored fundoplication and emerging anti-reflux devices (e.g., LINX and endoscopic modalities);
• Revisional and reoperative strategies in complex or recurrent foregut disease;
• Robotic, minimally invasive, and hybrid surgical platforms;
• Esophageal motility disorders and physiologic assessment in surgical planning;
• Integration of artificial intelligence and predictive analytics in outcome prediction;
• Quality-of-life evaluation and patient-reported outcomes after personalized interventions;
• Multidisciplinary frameworks linking surgery, gastroenterology, and perioperative optimization.

Article types welcomed: original research articles, reviews, technical reports, meta-analyses, perspectives, and consensus statements.

Dr. Elshafei has received honoraria from Implantica for presentation and proctoring activities.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Curriculum, Instruction, and Pedagogy
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Foregut Disease, Foregut Surgery, Upper GI Surgery, GERD, Esophageal Disorders, Hiatal Hernia

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.