Why is size of stomach SO small?

[TwoStepsBack 15]

Hey Guys,

I was just wondering if the op can be performed, but not quite as extreme? ie) Can they reduce the size of the stomach, but not to the degree of a normal VSG?

I only have about 87lb to lose, and feel that if I were able to eat perhaps 1cup of food per sitting then that would be enough restriction for me to lose weight, but still be getting enough nutrients and have energy etc.

Is there some reason why it has to be taken down so very small?

Thanks,

L xx

Edited July 27, 2010 by TwoStepsBack
incorrect goal loss

[Papillon 7]

I would talk to your surgeon. It really depends on what size they are willing to use. I am sure he/she would be able to work with you. : )

[TwoStepsBack 15]

Cool, yeah I'll do that. I didn't realise that is something surgeons will consider, I've not seen anything about it before.

[Papillon 7]

It never hurts to ask. Dr. P in AZ uses a size 40. I have seen people post about a size 32 or 34. It will be interesting to see what your surgeon says. : )

[Jane_J 117]

I am very happy with a 40 sleeve. Its a liveable size for me.

Jane x

[Tiffykins 672]

With a 32fr size sleeve, I can eat 1 cup of food if it's mushy consistency, and I eat super slow (over 40 minutes). I can eat 3-5oz of dense Protein comfortably without issue. 3oz if I want a few bites of veggies, 5oz if all I want is the Protein.

Remember, that what you will be able to eat at 2-3 months will nearly double at 1 year out. If you go too big, it's been shown in the earlier sleeve days when larger bougies were used that there is a higher incidence of significan regain. Discuss all the options with your surgeon.

[i1Linda 15]

I would second Tiffy's response. I can definitely eat more now tha I could 11 months ago. I am nearly a year out, have lost 98 lbs and can eat a cup of food now at one time. Sometimes I feel like my sleeve is too big because I eat more than I want to, and other times I wish I could eat more. With that said, I think it's perfect. My weight loss has slowed significantly (those last pesky pounds) but let's be honest, I have not been the model sleevester lately. But the pounds are still slowly dropping. FYI - I believe my doctor used a size 34 bougie.

[Jachut 487]

If they say the sleeved stomach wont stretch, why is it that you can eat more some way out?

[schaf921 0]

I was told that it would stretch but that the portion of the stomach left is thicker or less pliable than what was removed and therefore the amount it will stretch is very limited. Also, there is the swelling and healing that takes place

[Tiffykins 672]

If they say the sleeved stomach wont stretch, why is it that you can eat more some way out?

The initial swelling subsides, and the tissue forms to the "banana" shape after several months. It's not really stretching. I mean I guess it is to an extent, but essentially they're using an instrument no bigger than a marker as a measuring guide for the stapler to dissect the fundus, and our stomachs can not stay that small forever. After the first 4-6 weeks of liquids, and then mushies, the stomach becomes acclimated to that consistency of food, and then onto regular foods.

My stomach is at max capacity for life, and most sleeve patients will hit that stage between 7-12 months post-op.

My surgeon explained that it's not stretching really like what we see with pouches. It's like a man's trifold leather wallet. When they first get it, it's tiny, then after several months, wads of cash, receipts and several credit cards later, it stretches to an extent, but it reaches a point where it can't go anymore. That's kind of like what our stomachs do over that first year.

[brittu 42]

I've had to read just about every study every written on the sleeve as part of my insurance appeal. From what I've read, 32f seems to do the best when it comes to long term weight maintenance. Drs. Cirangle and Jossart have an ongoing study that's at 7 years now and their data is pretty convincing. But I think in general anything 40f or under is successful for over 80% of patients.

Part of why I went with Dr. Aceves is that he does a 36f oversewn down to a 32-34. I had damage from my band and wanted my sleeve oversewn based on the data I read. And I wanted a small stomach. I'm good at losing weight, I'm terrible at maintenance. Plus I have esophageal dilation from the band so I suspect my intake will be higher that most.

I think the advice to talk to your surgeon is good. And I'd also recommend checking out the studies on pubmed and springerlink to see what you think.

[TwoStepsBack 15]

Great advice everyone, thanks very much! xx

[NtvTxn 1,262]

My doctor uses a 32, I had a 3 oz tummy when he got through. When all is said and done, hopefully I will have lost what you want to lose. That is my goal. They said that in approx. 8 - 12 months I will be able to eat about a cup of food. Right now I can eat a half cup of cottage cheese, or 2 oz of shrimp or 2 oz of soft chicken, a fourth cup of tuna salad. It just takes time. I'm on week 8, I started out at maybe an eighth of a cup of soup!! If you come OUT OF SURGERY eating about a cup of food, then it stands to reason a year later you will be able to eat much more. I am not sure I'd want to adjust the normal surgical procedure, you might end up disappointed with the results several years down the road.

Hey Guys,

I was just wondering if the op can be performed, but not quite as extreme? ie) Can they reduce the size of the stomach, but not to the degree of a normal VSG?

I only have about 87lb to lose, and feel that if I were able to eat perhaps 1cup of food per sitting then that would be enough restriction for me to lose weight, but still be getting enough nutrients and have energy etc.

Is there some reason why it has to be taken down so very small?

Thanks,

L xx

[pumpkin07 32]

I have a 34, but wanted a 40. It seems fine though. I think the truth is most doctors have also done their research and are quite opinionated. My doctor was, and he said he only does a 32 or 34 b/c that is what research shows the most satisfaction with over time. My friend's doctor did a 40, but says it winds up smaller b/c of the way he sews it - as someone mentioned earlier.

Let your surgeon convince you of why he does the size he does - and see if it makes sense to you. I don't think, from what I've heard, that many doctors let the patient decide. I told my doctor I was concerned about getting too thin and so he did the larger of the two and that is as far as he would go.