A National, Multicenter, Survey-based Analysis of Clinical Practice and Utilization of Bougie in Metabolic and Bariatric Surgery

Background: Bougie is critical for achieving the optimal sleeve size or pouch creation in metabolic and bariatric surgery (MBS). This study investigates the clinical application and challenges of specialized bougie in MBS within China, aims to identify targeted solutions, and seeks to guide clinical practice. Methods: A survey questionnaire, developed in collaboration with MBS experts through a webinar, was distributed online to MBS centers across China from March 9 to 15, 2023. Statistical analysis was used to evaluate the survey responses. Results: The survey collected 183 valid responses from 28 provinces, including autonomous regions and municipalities. Of these, 86.34% of centers reported using specialized bougie for MBS, with 79.23% using it frequently. Among those frequently using bougie, 40.51% reused bougie postdisinfection due to the high costs of new bougies. The most common bougie sizes used were 36Fr for laparoscopic sleeve gastrectomy and laparoscopic gastric bypass, with other sizes ranging from 30Fr to 38Fr. However, 41.53% of centers reported complications related to bougie use, with tension rupture and esophageal injury being the most frequent. Conclusions: This nationwide survey offers insights into the clinical application and challenges of specialized bougie in Chinese MBS centers. There is a need for enhanced education, standardization, and training to mitigate complications and improve patient outcomes.