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Gastric Sleeve Bougie – The What, Why, When and How

Gastric-Sleeve-Bougie


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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.

Gastric Sleeve Surgery Bougie Size

What is the Ideal Size for a Bougie?

Diameter of Bougie in French Diameter of Bougie in Inches
32 F .40”
34 F .425”
36 F .45”
38 F .476”
40 F .5”
46 F .576”
60 F .75”
  • 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?

Function of Gastric Sleeve Bougie

  • 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

References

  1. 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
  2. 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/
  • Can you stretch a gastric sleeve?
  • What is a bougie in bariatric surgery?
  • Can you put weight back on after gastric sleeve?
  • Can you drink soda after a gastric sleeve?
  • Gastric Calibration Tube VSG
Updated on November 19, 2018

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