So, I was watching a video by dr Alvarez and he said that if you have a larger stomach he uses a larger bougie and smaller stomach =smaller bougie.

Them I see se surgeons say they use x size, always.

I've also heard people say " I think my sleeve is bigger than others, I can eat way more than other sleeve patients". I don't want that!!! Where can I read about drs success rates? Maybe that is what I need to be looking at?

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That's the one question I forgot to ask! I realized it after I left my appt on Tuesday.....I imagine my doc will use a 34, I've heard that from his other patients...

The difference in bougie sizes is measured in millimeters, so the difference between a 32 and a 40 bougie is smaller than the size of the word difference on your screen. What gives some people more capacity than others is their height. If you're taller, you usually have a longer sleeve, not necessarily wider.

Lissa I never thought about the length of my sleeve that makes sense...I am 5'10" and I bet it is longer than others...humm. Good reminder, thanks.

Sandy

I have a very long torso, so I have just a bit more room than some people. It is interesting the things you learn about anatomy on this site!

Lissa that reallyakes sense!! Thx

My surgeon uses a 34f (sounds like a bra size...lol). I also have a long torso, so this will be interesting.

My surgeon also uses a 34 french on everyone. He said that studies have show there is a higher risk of complications if you go smaller than that. He said the 34 seems to work for everyone and has the best success long term.

I think when measured out the capacity difference between the smallest bougie commonly used (I'm guessing 32) and largest (guessing 54) is about a teaspoon. I calculated it out once but right now I'm not remembering the exact number. As I've said before, none of us got MO on a teaspoon. So in terms of capacity, bougie size is basically a moot point.

A 32 Fr bougie has an inner diameter of... (get out calculator)... 0.4". A 40 Fr bougie is 0.5". That's a whopping one tenth of an inch difference. But also remember that bougie size and sleeve size are not the exact same.

The long term stats of % EWL losses between bougie sizes (at least the ones with long term results available) are virtually the same, if not exactly the same.

Surgeons used to (and maybe still do) follow the logic that a smaller bougie = smaller sleeve = better weightloss. Now they're seeing trends that smaller bougie = greater leak risk, and greater incidence of post-op GERD. The threshhold between higher incidence and no higher incidence seems to be the difference between a 32 and 34 Fr bougie, respectively. But even that's a bit arbitrary, and going to depend to a degree on the patient. My surgeon will not use anything smaller than a 34.

The average stomach is about 12" long and about 6" wide, with a standard capacity of about a quart. Tall people have longer stomachs? I think it's debatable. It's all just genetics and genetics favor proportion, mostly for survival, but we see a lot of exceptions every day. And I've seen a lot more studies refuting it than supporting it. ~1950 there was a study of 126 cadaver stomachs, and there was no significant correlation between stomach size and height, nor stomach size and weight, nor stomach size and gender:

Variations in stomach size are significant but cannot yet be explained. Differences in sex, age of patients, or body size do not account for the differences in the stomachs.

And from 2002:

While the heart and lungs are nearly the same proportion as body mass, many organs (e.g. liver, kidneys, and brain) are relatively smaller in larger individuals.

*shrug* Dunno. I know that I'm taller than most females here, have a Fr 34, and am eating less than most other posted quantities I pay attention to.

I think mine is one of the bigger sizes Ive seen used, a 40f, and I have plenty of restriction and am 15 pounds to goal. I have 5 kids and go to school full time. I can't imagine going through my day if I could only eat 2 T. of food. I can comfortably eat a cup of soup, half a sandwich (on light bread), a small slice of pizza, a side salad with 3 ounces of protein, 3 egg whites made into a small omelet. Those are typical of what I eat for quantity at one meal. My portions are small, but I feel like I eat a normal amount, just what a normal skinny person would eat.

Thanks everyone!!

Heather that's awesome!! You should post some pics!

I have 6 children, 10, 8,6,5,3,7m. I'm a saha tho.

I stayed home until this past year when my youngest went to Kinder. I am loving going back to school and getting a little bit of me back, plus I'm home before they get off the bus. Win/win! Mine are 13,12,10,7,5. It looks like we both had ours fairly close together. I had 3 in diapers for 8 months.....8 longgggg months.

I will post pictures if I can make them private. Anyone know?

I have a 38 French bougie, and my surgeon uses that size for everyone. I'm pretty short too and doubt that I have a long stomach. It seems like I can eat more than a lot of new sleevers, but I just eat until I am satiated. I can eat a whole taco from Taco Bell, but I don't go there very often. I can eat what Heather listed she eats. I also don't have much problem with liquids. I can get in a lot of liquid at once as long as I don't chug it and pause between a few gulps. Liquid gets absorbed very fast anyway so I doubt that has anything to do with stomach size.

I wonder too if scar tissue plays a role here. If scar tissue builds up around the incision line and staples on the outside of the stomach as well as the inside, could that be causing some restriction as well in our new stomachs?

I do think it is possible to get to have a few more bites with a bigger sleeve. I've heard a lot of sleevers who got their sleeve in Mexico say that they got a 30 or 32 and that they can take about five bites of Protein like steak. I can get in about ten bites and a tablespoon or so of Beans.

Wait, isn't a quart 4 cups (32oz)? I thought most stomachs were around 7-8 cups, which would be 2 quarts? It makes a big difference in how I am visualizing the stomach

I just went to his seminar and he said he always uses a 32 now because it is better in his opinion and you get better restriction.

I'm pre op so I can't answer from experience but I did ask my surgeon he said he used a 40f and stayed tight against it. He said a 40 is the smallest Lighted Bougie they have and with it being lighted he can see exactly where to staple. He said he has heard of surgeons actually stapling into the Bougie and it being a mess to deal with and he would rather be safe than sorry.