"I think that in general the idea is that it is not an ideal thing to do. HOWEVER, studies seem to show that those with weak peristalsis haven't had any worse post-Nissen outcomes than those without peristalsis."
The studies just don't make sense to me. If I strengthen the LES my motility should get stronger. But if my motility is weak won't the strengthening of the LES exaggerate the weak motility and cause a patient a great deal of dysphagia.