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SAGES 2026 Annual Meeting Emerging Technology Session
March 25-28, 2026 | Tampa, FL, USA
P631
Esophageal Bougie Use Does Not Improve Outcomes in Paraesophageal Hernia Repair
Poster Presenter
Authors
Sami O Abul-Khoudoud, Joshua L Lyons, Emily F Simon, Trisha Lal, Natalie Chakraborty, Kayvan Barekatain, Jill Knepprath, Hamza N Chatha, Saher-Zahra Khan, Patrick Wieland, Nicolette M Winder, Samuel J Zolin, Jeffrey M Marks
Affiliations
University Hospitals Cleveland Medical Center/Case Western Reserve University
Part of Topic
Foregut
Esophageal Bougie Use Does Not Improve Outcomes in Paraesophageal Hernia Repair
BACKGROUND
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Esophageal bougies are often used during paraesophagealhernia repair to guide hiatal closure and wrap sizing.
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Prior literature suggests no clear benefit for dysphagia orrecurrence after hiatal hernia repair.
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Objective: This study compared outcomes after PEHR withversus without intraoperative bougie use
METHODS
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Retrospective cohort from a single academic institution,2010–2023.
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Adults with BMI ≥ 18.5 undergoing elective, first-timePEHR without concomitant procedures.
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Primary Outcome: Postoperative dysphagia.
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Secondary Outcomes: 30-day complications, readmission,GERD, recurrence, and reoperation.
RESULTS
Cohort Characteristics (N = 839 PEH Repairs)
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Bougie Use: 463 (55%)
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Fundoplication: 582 (69%) — Nissen: 408 (70%); Partial: 172 (30%)
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Demographics: Well-matched baseline characteristics across all bougie and wrap cohorts.
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Full vs. Partial Wrap: Patients undergoing a full wrap were significantly older (64.4 vs 62.4 years;p<0.001) and more likely female (81.9% vs 74.7%; p<0.001).
CONCLUSION
CONCLUSION
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No Overall Benefit: Routine intraoperative bougieuse during PEHR is not associated with improvedprimary or secondary outcomes, includingpostoperative dysphagia.
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Strategy Independent: This lack of clinical benefitpersists regardless of the fundoplication strategyemployed (none, partial, or full).
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Clinical Takeaway: These data support a selective,rather than routine, approach to bougie use duringhiatal hernia repair.