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Gastric sleeve surgery or vertical sleeve gastrectomy (VSG) is a common weight loss surgery performed to combat obesity. It involves removal of almost 75% of the stomach and creating a sleeve out of the remnant stomach using a device called a “bougie.” The bougie size is important as it plays an important role later on, while determining your quality of life.
What is a Bariatric Surgery Bougie for Sleeve?
- A measuring device that was created in France, a bougie is essentially used to divide the patient’s stomach during the gastric sleeve surgery.
- The tube is placed into the mouth of the patient and carefully pushed through the esophagus and the stomach
- It ultimately rests at the pylorus.
- This bougie comes in different sizes and is measured in French, where 1 French (F) is one-third of a millimeter.
What is the Ideal Size for a Bougie?
|Diameter of Bougie in French||Diameter of Bougie in Inches|
- The smaller the bougie, the smaller the stomach.
- If a bigger bougie is used, it guarantees a safer surgery but then, the expected weight loss is not ideal, in most cases.
- The size of the bougie is calculated on the basis of the patient’s height and weight, BMI and the technique that the surgeon will use to carry out the surgery.
- A smaller gastric sleeve bougie would result in a smaller pouch but would risk the increase of gastric sleeve leaks and strictures.
- It is important to discuss the size of the bougie with the surgeon and understand the reasoning behind it.
- In the United States, bougie sizes range from 30F to 50F.
- The size of the gastric sleeve bougie varies from case to case. Generally, a smaller size bougie results in a longer hospital stay and is coupled with increased nausea and readmissions.1
- A study by Carlos Hoyuela proved that when the gastric sleeve was created using a 34 F bougie, it is highly safe and effective in reducing weight.2
Why is a Bougie Used?
- The purpose of the bougie is to create a bulge in the stomach that guides the surgeon on how to staple the stomach to form a stomach sleeve.
- The bougie does not guarantee an exact size of the stomach as it is only a guide for the surgeon.
- The size of the new stomach also depends on whether or not the surgeon over-sews the staple line.
- The stomach can normally hold 64 ounces of food. Gastric sleeve surgery reduces this number to approximately 15 ounces.
Source: National Bariatric Link
- Hawasli A, Jacquish B et al. “Early Effects of Bougie Size on Sleeve Gastrectomy Outcome”. American Journal of Surgery (2015) 209(3): 473-7. Web https://www.ncbi.nlm.nih.gov/pubmed/25578744
- Hoyuela, Carlos. “Five-Year Outcomes of Laparoscopic Sleeve Gastrectomy as a Primary Procedure for Morbid Obesity: A Prospective Study.” World Journal of Gastrointestinal Surgery4 (2017): 109–117. PMC. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406732/
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