I everyone, I am scheduled for VSG surgery on July 27th. I have been dealing with the staff of my surgeon but I hope to talk to him soon in more detail about the procedure.

I found he uses a size 46 bougie. My guess for this size would be to complete the second step RNY or DS if needed. My goal is only to have the sleeve done even though insurance will not pay unless it is considered a 2 part surgery with a rny or ds being the second stage. Thankfully there is nothing that states I will need to have the second surgery so my plan is to do well enough with the sleeve.

Anyway, I do not see many posts with doctors using a size 46 bougie. What are some questions I should ask my surgeon when I see him? I want to stress to him that I think the sleeve is the best surgery to have and that I do not want the RNY or DS after unless I am not losing the weight.

Thanks

I everyone, I am scheduled for VSG surgery on July 27th. I have been dealing with the staff of my surgeon but I hope to talk to him soon in more detail about the procedure.

I found he uses a size 46 bougie. My guess for this size would be to complete the second step RNY or DS if needed. My goal is only to have the sleeve done even though insurance will not pay unless it is considered a 2 part surgery with a rny or ds being the second stage. Thankfully there is nothing that states I will need to have the second surgery so my plan is to do well enough with the sleeve.

Anyway, I do not see many posts with doctors using a size 46 bougie. What are some questions I should ask my surgeon when I see him? I want to stress to him that I think the sleeve is the best surgery to have and that I do not want the RNY or DS after unless I am not losing the weight.

Thanks

That is a pretty darn big bougie. Personally, I would not permit a 46F bougie for a straight sleeve. For a two part procedure.. yes. But not for a sleeve only.

Short term studies show weight loss is similar to a smaller sleeve, long term studies are not leaning towards good news with a large bougie. In Chile they use a 60F, those folks are not doing well at all.

I have a 32F stomach, my surgeon currently uses a 36F and oversews the staple line bringing it down to a 34F. There is no statistical difference between a 32F vs. a 38F that I can find. But 46... here is the difference:

Take the bougie size (such as 34) divide by pi (3.14) and you get the diameter of the stomach:

32F = 10.19mm

34F = 10.82mm

36F = 11.46mm

38F = 12.10mm

40F = 12.73mm

46F = 14.65mm

60F = 19.10mm

So the diameter of your stomach will be about 40-50% bigger than most sleeved people. But, the flip side to that coin is that it is still quite small.

ETA: You might check out the link in my sig for researching a VSG surgeon, it's written for Mexican surgeons but it will work quite well for US surgeons as well. That should give you many ideas on what to ask.

Edited June 16, 200917 yr by WASaBubbleButt

I agree with Wasa... 46 is too large. Let your surgeon know you want a smaller one.

Oh Lord, I can't spell. I really do know the country of Chile is spelled with an E. I just corrected that post. How embarrassing! ;o)

BAD SPELLERS UNTIE!

It luked lyke it was speled corectlie to me? But, you wouldn't know I can't spel eather.

It luked lyke it was speled corectlie to me? But, you wouldn't know I can't spel eather.

Shur yu kan! I kan reed it just finely.

My surgeon was using a 48 f and his patients were regaining their weight at 2-3 years out. He uses a 32 f now and this is less of a problem. The regain stats are more in line with the DS and better than bypass and the initial weight loss is similar to bypass. (He's done over 1000 of the things and has been doing them for over 7 years.)

Because of that, I wouldn't use a surgeon who was using a boughie over 30 something.

Oh Lord, I can't spell. I really do know the country of Chile is spelled with an E. I just corrected that post. How embarrassing! ;o)

BAD SPELLERS UNTIE!

It luked lyke it was speled corectlie to me? But, you wouldn't know I can't spel eather.

Shur yu kan! I kan reed it just finely.

Aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it deosn?t mttaer in waht oredr the ltteers in a wrod are, the olny iprmoetnt tihng is taht the frist and lsat ltteer be at the rghit pclae. The rset can be a total mses and you can sitll raed it wouthit a porbelm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe. Amzanig huh?

When I went to the seminar last week I asked the doctor if he uses an boughie and he corrected me on how I said it... LOL - but he said that he and the other doctor chooses to use an Endescope over a Boughie- Size is 32F............ So I was happy with his response.

What is this B thing?

that was hard to type wasnt it? Actually harder to type than read I assure you.

It's basically just a tube. They stick it down your throat and use it to size the stomach.

Oh OK, thanks.

Any studies done on the amount of grehlin remaining from the 36F boughie vs the 32F? Even if the staple line is oversewn to make a smaller diameter sleeve, would grehlin still be more of a problem than a straight 32F or 34F?

Any studies done on the amount of grehlin remaining from the 36F boughie vs the 32F? Even if the staple line is oversewn to make a smaller diameter sleeve, would grehlin still be more of a problem than a straight 32F or 34F?

Nahhh, the difference between a 32 and a 34 bougie is about 1/2 of a millimeter. About the thickness of your pinkie fingernail.

As long as the fundus is fully dissected, the ghrelin making part of the stomach is gone.

I do think that some DS patients with their larger sleeves don't end up with the fundus fully dissected. But I also think that may be because of technique in some cases. I don't think the surgeons realized how important that was until recently.