**Core Concept**
Gastroesophageal reflux disease (GERD) is a chronic condition characterized by the reflux of stomach acid into the esophagus, leading to symptoms such as heartburn and dysphagia. The primary goal of surgical intervention in GERD is to restore the antireflux barrier and prevent further acid reflux.

**Why the Correct Answer is Right**
Fundoplication is the operation of choice in GERD because it involves wrapping the upper portion of the stomach (fundus) around the lower esophagus to enhance the antireflux barrier. This procedure is effective in reducing symptoms and preventing complications such as esophagitis and stricture. The laparoscopic approach to fundoplication has become increasingly popular due to its minimally invasive nature and reduced recovery time. The mechanism of action involves the creation of a 360-degree wrap around the esophagus, which increases the pressure in the lower esophageal sphincter and prevents acid reflux.

**Why Each Wrong Option is Incorrect**
**Option A:** Highly selective vagotomy is a surgical procedure that involves cutting the vagus nerve to reduce gastric acid production. However, it does not address the underlying issue of acid reflux and is therefore not the operation of choice for GERD.

**Option C:** Heller's myotomy involves cutting the muscle fibers of the lower esophageal sphincter to relieve dysphagia in cases of achalasia. While it may provide temporary relief from symptoms, it does not address the issue of acid reflux and can potentially worsen it.

**Option D:** Gastrectomy involves the removal of the stomach and is typically reserved for cases of gastric cancer or severe peptic ulcer disease. It is not a suitable treatment option for GERD, as it can lead to complications such as dumping syndrome and malnutrition.

**Clinical Pearl / High-Yield Fact**
The laparoscopic approach to fundoplication has been shown to have a lower complication rate and faster recovery time compared to the open approach. Additionally, the use of a 360-degree wrap has been associated with improved outcomes and reduced recurrence rates.

**✓ Correct Answer: B. Fundoplication**