Hi All,

I got around to speaking to Dr. Ramos and he seems really great. Eased my fears and answered all of my questions. In our discussion he told me he uses a 36 French Bougie. With Dr. Rod, it was a 32. Dr. Ramos said he could do a 32 if I would like, but he normally does a 36 and the way he sutures makes it a little smaller. I was going to ask him is opinions on a 34 bougie. If you could respond and let me know your bougie size and weightloss at 6 months (even though I know everyone is different), I just wanted to see if there was a huge difference.

Thanks

Found out he uses a 36 bougie but sutures over the staple line making the stomach smaller. Wondering if it makes it as if he had used a 34 bougie.

The difference between a 32 and 36 is a less than 2mm. It has little to do with the final size of the sleeve. It will more be determined by your own anatomy (length of stomach) and surgeon technique. A surgeon can use a 32fr bougie, but not dissect the fundus completely or leave more tissue closer to the pyloric valve and your capacity will be different than a different patient with the same size bougie. Your surgeon could use a 36fr, oversew, get all the fundus, and you might have a short little stomach and not be able to eat as much as me with a 32fr bougie used during surgery.

Essentially, the bougie is only a small part of the equation. Now, with bougies over size 40-44fr, that's where the higher incidence of weight regain is seen at 2-5 years post- VSG.

I'd be more concerned with surgeon stats, experience and technique.

The stomach size is dependent on so many variables ... bougie size, how close the surgeon cuts/sutures to the bougie guide, how long your stomach is, etc. One concern of going too small is causing strictures which you don't want.

My surgeon used a 36 and cut/sutured close. Some use 32 and leave room. Ask your surgeon how "close" he goes ... of course, you won't have control of your stomach length. However, no matter what size, it is going to be SOOOOOOOOOO much smaller than what you have now.