Hi Dr. Jossart:

My question is about the size of the VSG. I'm having surgery in 2 weeks, and I'm wondering if different doctors do the sleeve different sizes? What is the standard? Is there a variation on the standard? What are the benifits or risks associated with the different sizes?

I'm not sure how the determine how much room you'll have but was told by my Drs. about a bougee, some sort of tube placed in the stomach for the surgery to make sure it can't be too tight. Perhaps others can verify this.

bougie [bo̅o̅′zhē, bo̅o̅zhē′] Etymology: Fr, candle

a thin cylindric instrument made of rubber, waxed silk, or other flexible material for insertion into canals of the body in order to dilate, examine, or measure them.

Surgeons use anywhere in the measurement called a french of 32-40. Most prefer a 32 unless they double stitch so that the stomach is tighter than that afterwards. A 40 is used for DS because of malabsorption added to the process. It's best to ask the surgeon you pick what size they prefer. You can always ask for a size.

Some surgeons leave a 'pouch' after the sleeve, so some people can hold more than others after surgeries with the same french size.

Sleeve size is the number one controversy with the VSG. Many patients undergo this operation and are left with too big of a pouch. The optimal pouch size is created with a 32 French bougie and even then a surgeon could staple loosely on the bougie and create too large of a pouch. Given the correct size pouch, most patients with a BMI under 50 achieve a BMI under 26.

Sleeve size is the number one controversy with the VSG. Many patients undergo this operation and are left with too big of a pouch. The optimal pouch size is created with a 32 French bougie and even then a surgeon could staple loosely on the bougie and create too large of a pouch. Given the correct size pouch, most patients with a BMI under 50 achieve a BMI under 26.

Dr. Jossart:

In the event the sleeve size is too large, isn't it still significantly different for it's new owner? As of today, I feel like I could eat two full plates of food. Even if I am sleeved with the "too large" sleeve, won't it still have a significant impact (therefore improvement) in my weight management? I don't mind some of this being my job but I'd love a smaller stomach to be a part of the tool kit. Is it possible you could have this surgery and not even notice restriction the sleeve is so large?

Thanks.

If this helps my surgeon aims to leave you with a stomach capacity between 125 ccs and 150ccs. I can eat 6 oz of steak at a go, but I am stuffed then. I am 17 months out now and at goal.

Jane x