I have read a lot of places that say that the sleeve is usually only used as a 2 step process, first getting the sleeve then having gastric bypass later. Is it always a 2 step surgery like this? Or did you just have the sleeve done?

Just the sleeve for me. It's been done as a stand alone surgery for around 5 years apparently.

The sleeve gastrectomy originated as part one of a two step procedure. It was used for those who were too obese for more invasive surgery; they would get the sleeve and after losing down to a safer BMI would get the duodenal switch as the second part of the process. When the sleeve was done in this manner, a larger bougie was also used. When they found that people were losing adequate weight with the sleeve alone, it was developed as a stand-alone procedure, using a smaller bougie.

Hope this helps!

The sleeve gastrectomy originated as part one of a two step procedure. It was used for those who were too obese for more invasive surgery; they would get the sleeve and after losing down to a safer BMI would get the duodenal switch as the second part of the process. When the sleeve was done in this manner, a larger bougie was also used. When they found that people were losing adequate weight with the sleeve alone, it was developed as a stand-alone procedure, using a smaller bougie.

Hope this helps!

What is a bougie?

What is a bougie?

A bougie is a tube that is inserted down your throat into your stomach during surgery to guide the surgeon where to make the incision. So, the larger the bougie, the larger your sleeve will be and vice versa. Average bougie size is 32-38 according to my surgeon, who uses a 34, but they can go up to a 60.