When performing a Gastric Sleeve Surgery we remove a part of your stomach (around 80%) leaving the remaining of the stomach in a tube shape (or sleeve shape). To calibrate the size of the stomach we use a calibration tube commonly known as: Bougie.
The Bougie is made out of soft and flexible silicone with the capacity for internal aspiration. This serves to aspirate the stomach during Gastric Sleeve surgery. It is inserted through the mouth once the patient has his airway secured to avoid the risk of aspiration pneumonia, the anesthesiologist introduces it into the stomach under the surgeons direct vision.
There are different Bougie sizes and are measured in Fr units; 1mm equals 3 Fr units. When introducing the bougie gets difficult, an endoscopy is made to verify and check, most flexible endoscopes have a diameter of 9.8 mm, so in these cases an endoscope can be used as a calibration tube and/or as diagnose tool. When explaining to our patients the Gastric Sleeve and the rol of the calibration tube, one of the most common questions I get is: Does Bougie Size matters in a Gastric Sleeve?
In a gastric sleeve, the calibration tube is very important, not only to guide the size of the sleeve but also to avoid areas of stenosis and to properly achieve a gastric sleeve. Two factors that will impact weight loss and the patient quality of life.
The size of the bougie is extremely important when stapling the stomach, the bougie serves as a tutor or guide to the stapling line. If a small calibration tube is inserted but the surgeon places the stapler in a wrong distance from the guide (bougie), this can lead to very tight sleeve with a higher risk of stenosis or leakage, or inadequate weight loss if the sleeve is to loose.
The worldwide consensus , states that the bougie should be between 32 and 36 FR, in order to achieve adequate results and reduce the risk of complications. I personally prefer 36 fr size bougie, is the safest and with most effective long term weight loss.
If you are looking to learn more Bougie Sizes or have more questions about Gastric Sleeve Surgery technique, don’t hesitate to contact us, one of our patient coordinators can help you. Or call 1 (833) 463-9263.
Laparoscopic sleeve gastrectomy: does bougie size affect mean EWL Short-term outcomes (https://www.ncbi.nlm.nih.gov/pubmed/18656834_