In Nissen fundoplication for GERD, the wrap is constructed as a 360° fundoplication around the intraabdominal oesophagus over a calibration bougie of approximately:

• A 28–32 French bougie
• B 40–44 French bougie
• C 56–60 French bougie ✓
• D 70–72 French bougie

Explanation

During laparoscopic Nissen fundoplication, a 56–60 French oesophageal dilator (bougie) is passed into the oesophagus before constructing the wrap to calibrate the tightness of the 360° fundic wrap. Using a bougie of this size prevents the wrap from being too tight, which would cause postoperative dysphagia, while ensuring it is snug enough to prevent reflux. A wrap that is too loose or too tight causes the most common complications (reflux recurrence or gas bloat/dysphagia respectively).

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.