Dear editor,

We thank Dr. Beumer and Dr. Shenfine for their letter and useful comments. Although we agree that a longer follow-up is desired, a first-year data is important since it covers the time when most of the weight comes off and most of the complications happen. The limitations of this study were made clear in the paper, and it certainly should not be considered as the final say on the subject. We will continue the follow-up on this cohort and look forward to report long-term outcomes in the future. Hopefully, this study will encourage other investigators to revisit the “ideal bougie size” too and to bring more data and discussion on this issue.

Hadar Spivak, MD FACS