It is a medical device that a doctor has to order and prescribe.It's green,two feet long,tapered and has a heavy titanium vertabrae spine under the rubber.You cover a then layer of water soluble lube on the bougie and ram it down your throat.Count one thousand one,one thousand two,then pull it out.It's simple,easy,no bill deal and helps to keep the pipe streched out. I HIGHLY recommend it if you have scar tissue in the throat area from radition and are having a hard time getting food down.