Hi, hope you are well?!
Here, I would like to give you a deeper insight into how gastric sleeve surgery is performed.
Gastric sleeve surgery (sleeve gastrectomy) is a bariatric procedure in which approximately 70–80% of the stomach is removed, leaving a narrow, tube-shaped stomach. Its main function is to reduce food intake and decrease hunger hormones, helping patients achieve significant and sustainable weight loss and maintenance.
Gastric sleeve surgery, together with gastric bypass, is one of the leading bariatric procedures worldwide, and in recent years it has become the most commonly performed method, accounting for more than 50% of all bariatric surgeries globally.
How Gastric Sleeve Surgery is preformed?
To create a precise and consistently shaped gastric sleeve, surgeons use a specialised calibration instrument called a bougie.
It is a soft, flexible silicone tube that is inserted through the mouth, down the oesophagus, and into the stomach during the operation.
Its purpose is to help surgeon to create a sleeve that is straight, uniform, and anatomically precise.
How is a bougie measured?
Bougies are measured by their diameter using the French (Fr) scale, an international medical sizing system:
- 1 French (Fr) = 0.33 mm
For example:
- 32 Fr ≈ 10.7–11 mm diameter
- 36 Fr ≈ 12 mm diameter
Bougies used in bariatric surgery typically range from 28 Fr to 40+ Fr.
After gastric sleeve surgery, the stomach volume of approximately 100–150 ml.
Bougie size matters
The size of the bougie, your surgeon chooses, directly influences the size of the newly created stomach sleeve, which in turn can affect your:
- Weight-loss outcomes
- Risk of complications
- Long-term tolerance of food
- Symptoms such as reflux, nausea, or vomiting
Studies and practice show that moderate bougie sizes (typically 32–36 Fr) offer the best balance between:
- Effective weight loss
- Lower risk of complications
- Better long-term patient comfort
Very small bougies (narrow sleeves) may increase the risk of:
- Nausea and vomiting
- Acid reflux
- Strictures (narrowing of the stomach)
Very large bougies may:
- Reduce the effectiveness of weight loss
- Lead to earlier stomach stretching and weight gain over time
For this reason, most experienced bariatric centres favour a balanced, patient-safe approach, rather than extremes.
Our Surgeons' surgical approach
At Weight Loss Latvia, gastric sleeve surgery is performed at Sigulda Hospital by a team of two experienced general and bariatric surgeons Dr Olegs Kozlovskis and Dr Juris Zarinovs.
In the majority of cases, our surgeons use a 36 Fr bougie, as this size is widely supported by clinical evidence and international best practice.
Importantly, the final surgical approach is always based on:
- The patient’s anatomy
- Medical history
- BMI and weight-loss goals
- Overall safety considerations
Bariatric surgery, including gastric sleeve, is one of the most effective treatments for severe obesity and weight-related conditions such as type 2 diabetes, hypertension, sleep apnea, and joint or back pain, offering many people the opportunity to regain their health and enjoy a significantly improved quality of life after years of struggling with weight loss.
If you would like to learn more about gastric sleeve surgery or discuss whether it is suitable for you, we are always here to help.
For inspiration - here is our patient Natalie before and 1 year after her gastric sleeve surgery at our hospital.
Warmest regards,
Ilva Urbanovica
Weight Loss Latvia
📞 +371 29148884
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