So I met with my surgeon today and asked him how big my sleeve would be. I see everyone on here talking all these numbers and I wanted to know mine. He said I will have a sleeve the size of 15 cc's. He sounded so sure of himself that I didn't question him any further. Originally I said I wanted gastric bypass, but he convinced me to go with the sleeve. So he said because I wanted gastric originally that he was going to make my sleeve the same size as he makes his gastric patients' pouch, which is 15cc's. So what exactly would that be in Bougie terms. I'm lost.

I just get so nervous in the Surgeons office that I fumble around with what I want to say. If anyone knows anything that could help me I would appreciate your feedback.

My doc uses a 40 and I have zero relux. My doc says anything smaller does put you at risk for complications but that doesn't mean you will get them. I can eat about 3/4 cup of food.

lol that is funny!

i can only manage about 1/4 cup to 1/2 cup of food at a time, and that depends on the type of food. i also feel like some times of the day i can eat more than others. i am only 2 months out though, so it probably will get to be more. i dont push it though, i would rather under eat then over do it, feel yucky and stretch out my little sleeve

My doc used a 36, and over sewed. He said that the size of the bougie does not tell the size of the stomach... its just a guide. He makes the stomach larger at the pylorus end... saying that too tight a cut there can cause problems. I went off antacids at about 8 months, and no problems. I have never had any problems. No acid, no pains, no vomiting. I can eat quite a bit... protein about 1/2-3/4 cup.... Other things even more. But the stomach knows when to quit, and I am still s-l-o-w-l-y losing weight.

Dr. Aceves told me the difference between ad 32 and a 36 is about a teaspoon. I was worried at first because I always heard he used a 32, so I asked him when I went back to Mexicali for my face lift in May.

I asked him what size he uses because I've heard different things on the boards. He told me he always uses a 36 to leave room for oversewing . I looked on my records he had sent home with me originally, and sure enough it says 32.

I certainly would not want it any smaller. At 2 1/2 years post op, I still eat way less than a child's portion.

Mine is 36cc

Thanks for bringing this subject up. This is one of the things on my checklist when I meet the surgeon who I will be referred to after I finish the Options pre-op program at Kaiser, southern California. I finish the pre-op program Dec 13 and then will be waiting to be contacted for an appointment with the surgeon. I certainly would not want a pouch that is so small that I ended up with reflux issues.

I totally didn't even ask about it till the surgery was over n wish I had remembered such an important question. He used a bougie and some surgeons just eye ball it.

Thanks for bringing this subject up. This is one of the things on my checklist when I meet the surgeon who I will be referred to after I finish the Options pre-op program at Kaiser, southern California. I finish the pre-op program Dec 13 and then will be waiting to be contacted for an appointment with the surgeon. I certainly would not want a pouch that is so small that I ended up with reflux issues.

...... I certainly would not want a pouch that is so small that I ended up with reflux issues.

...just a technicality.... but we don't have a pouch, that is a term used for a RNY stomach... we have a sleeve. They are built differently. I have a 36... but surgeons make them loose, tight, oversewn, glued, larger at the pylorus end...and with no bougie at all as mentioned above... the bougie number only tells part of the story. I agree too small can cause problems, but if you have a good and experienced surgeon, the size will be fine Im sure.

MIne's a 32. My surgeon said that at the infancy of the sleeve surgery advent, most docs used 40-46, but quickly found that was too large for most to keep the weight off for years (based on research done for DS conversion pts and other country's stats, since ours are too new to tell long-term). Since your stomach eventually loosens (don't want to say stretch, but that can also be used), the 40-46 was allowed too much room and not enough restriction years out and patients started gaining their weight back. They started dropping the bougie size to see what was the 'best' size for restriction, overall complications, and long-term restriction (over 5 years). Much of the research at the beginning showed that the 32 size can have issues with complications, but that is based on the surgeon and is now very rare as they have all have more experience and the sleeve is becoming much more common. In the beginning, using a thinner 32 Fr bougie tube could create a somewhat 'hourglass' shape in the middle of the new stomach, where the inner curve lies. But he also said that most surgeons know that now, and avoid that complication by leaving extra room at the opposite side of the curvature, which will prevent the possible stricture issue. And using a smaller Fr size, it keeps the stomach from stretching too much, or reaching a higher level of fill capacity years down the road.

So, hope that helps....he really explained this to me thoroughly and it makes so much sense! I'm so happy with my 32. I am 4 weeks out and can eat two scrambled eggs for breakfast! But that's not the bougie size, as everyone is soooo different in what they can eat and tolerate. Some after a year can't even eat a whole scrambled egg!

But to be completely honest? I think the 15cc size is way too small - that's only 3 teaspoons, or a tablespoon!. Most sleeves, after surgery and after the swelling goes down, can hold up to two-four ounces. Later on, maybe 6 ounces once you hit your year mark and your own 'normal'.

I would ask your surgeon some more questions, just to be on the safe side and to be sure the size you need and want are adequate to live with :hug:

Generally the smaller the number the bigger the tube. Are bougies different?

Generally the smaller the number the bigger the tube. Are bougies different?

Hahaha! Looks like it. good point.

Also I think it is more accurate to say how much volume your stomach can hold, not weight. I can eat a cup + of some things (soup), and 1/2 cup of others... dense protein, and the time of day makes a difference how much as well...

One thing to keep in mind......bougie size is not everything. Surgical skill is a MAJOR factor in determining the end size of your sleeve.

It takes A LOT of skill to get a tight 32 sleeve and to have it well shaped with no complications.

If your doctor recommends a particular size.....I honestly would go with that one.....or find a different doctor. Don't negotiate size. They are doing that size for a reason and it might be because that is the smallest they feel comfortable doing.

Also, not all sizes are the same. There are surgical techniques that can be used (oversewing, etc) that can make a 36 or 38 hold the same volume as a "loose" 32.

Some people have shorter or longer stomachs too... so the sleeve can hold more or less....