Background

Calibration bougies are common in most bariatric operations including gastric bypass, sleeve gastrectomy and one anastomosis gastric bypass. Standardization of bariatric operations continues to be a challenge. Measurements of gastric pouchs are often estimates rather than accurate measurements. Passage of bougies through the esophgeal hiatus poses potential challenges with poor visualization in the mediastinum and cases of esophgeal perforation have been reported.

Methods

Florscent guded gastric calibration tubes inorporated florescent markings at one cm increments. These may improve mediastinal esophageal visualizaiton and allow precise measurements of gastric pouch length during sleeve gastrectomy, gastric bypass and esophageal operations. We utilized a florscent guided calibration tube to evaluate its abiltiy to improve mediastinal esphageal dissection during magnetic sphincter augmentation device placement, creation of a sleeve gastrectomy using a 23 cm single cartridge stapler and measurement of pouch length in one anastomosis gastric bypass

Results

Florescent guided gastric calibration significantly improved visualization of the medistinal esphagus during mediastinal dissection and placement of a magnetic sphincter augmentation device. Visualization of the calibration marks during sleeve gastrectomy using a 23 cm single cartidge stapler successfully allowed precise measurement of the sleeve length allowing for enhanced standardization while using a stapler designed to specifically allow for a standardized sleeve gastrectomy. OAGB where increased gasstric pouch length has become increasingly recomended allowed for improved measurement of pouch length where standard 40 french bougies can't.

Conclusions

Florescent guided gastric calibration can potentially improve standardization of bariatric operations and decrease risk of mediastinal dissection