Aim: To evaluate incidence of post operative dysphagia and Quality of Life (QOL) after laparoscopic Nissen fundoplication (LNF) without bougie, based on Gastroesophageal reflux disorder–Health related Quality of Life Questionnaire (GERD–HRQL).

Study Design: A pilot study to analyze postoperative dysphagia in patients who underwent LNF/Laparoscopic assisted fundoplication (LAF) without esophageal bougie from January 2014 through June 2017. Patients without follow up of at least 6 weeks were excluded.

Methods: Patients who underwent LNF/LAF without use of bougie were analysed using GERD–HRQL questionnaire proposed by Velanovich⁽²⁾ et al for heartburn, regurgitation & dysphagia. GERD–HRQL was administered pre & post operatively and the scores noted.

Results: Out of 16 patients, 14 patients underwent LNF, 2 had LAF. One was lost to follow up. Median preoperative GERD–HRQL overall score was 34 & post operative score: 4. Post operative Dysphagia (grade 2) which persisted for more than 6 weeks occurred in 2/15 (13.3%).  Median heartburn scores were 14 and 2, pre & post procedure. Median regurgitation scores were 15 and zero. 8/15(60%) had postoperative gas bloat and 5/15(38%) patients continued to take proton pump inhibitors. Satisfaction towards the procedure was assessed, 10/15(66.6%) were satisfied with procedure, 4/15(26.6%) were neutral and one patient (6%) was not satisfied with the procedure. 

Conclusion: The incidence of postoperative dysphagia after LNF/LAF without esophageal bougie is comparable to that with bougie in literature and hence its routine use with attendant risk of perforation may not be warranted.