Do any of you know the bougie size that was used in your weight loss surgery? Can any of you attribute your success or failure to that bougie size?

The bougie size used on my sleeve was a 38. I lost 100lbs very quickly but I started to lose restriction within 8 - 9 months. I am three years out and I am seeking a revision because I have regained most of the weight I lost.

A year ago I had to have a scope because if reflux disease and I was devastated to learn that stomach was large/normal. In fact, my gastroenterologist told me he would found it hard to believe that I'd had a sleeve gastrectomy if I hadn't told him.

I believe the bougie size plays a huge part in wether the sleeve will be successful long term. The sleeve will eventually stretch no matter what the initial bougie so the start size is extremely important. No matter what op you have it is the restriction that is the most important tool; if you lose that tool then it seems like your back to square one.

Xxx

http://www.obesityhelp.com/forums/vsg/4517656/Bougie-Size-Infamous-Pen-Photo-Question/

It's the tool/size guide they use when making up your sleeve.

Xx

My surgeon said it almost doesn't matter what size it is because you don't know the surgeons technique. He said some go up right against it and some pull away from it some.

Yes, my original surgeon told me that he goes in tight to the bougie...(lol, sounds like a dance move)...but he told me that bougie size does and can affect the weight loss outcome but he wouldn't go lower because of the complications that are more likely to occur afterwards.

Xx

I would like to stretch mine out a little. The amount of food I can eat now is really really tiny. I went to Chipoltle today and I got some taco's. No rice, minimal Beans, meat and tomatoes. I got about halfway through the first one and I was done. I am still learning to accept that stopping point. It's tough.

You don't need to stretch it out any! Trust me.

You are still newly sleeved (not even 6 months yet) there is a reason they call this the honeymoon (best losing window) period. Like over night capacity will change.. not back to pre sleeve but compared to what you got used to eating it will feel like it.

Your stomach is still not healed all they way it will relax on its own and you can eat a bit more.

I can eat a taco... I wish I couldn't but I can..

And then I woke up today 2 pounds less than I was yesterday and it made it all worth it!! I LOVE my sleeve. lol

I had asked my dr if it were normal to be eating the amount that I can eat only two months out... For example, I can eat a whole Greek light & fit yogurt or most if not all of a weight control oatmeal before feeling full. My dr said that it has more to do with consistency & how quickly food is allowed to exit the sleeve & every person is different. Lean or dense protein tends to stay there longer, so I'd be able to eat far fewer oz of steak than yogurt. I don't tend to lose unless I am in the 1000-1200 calorie range each day, so it would be really tough to get it all in in 2 oz increments & still get the water in! Hope I'm doing everything right...

I had asked my dr if it were normal to be eating the amount that I can eat only two months out... For example, I can eat a whole Greek light & fit yogurt or most if not all of a weight control oatmeal before feeling full. My dr said that it has more to do with consistency & how quickly food is allowed to exit the sleeve & every person is different. Lean or dense Protein tends to stay there longer, so I'd be able to eat far fewer oz of steak than yogurt. I don't tend to lose unless I am in the 1000-1200 calorie range each day, so it would be really tough to get it all in in 2 oz increments & still get the Water in! Hope I'm doing everything right...

You are so not far out from your operation though so still on the soft food. You are still healing too so I believe that your stomach could be swollen thus allowing more in.

And you are right, leaner and denser food is going to help.

Good luck xx

SnowDaisy I'm curious how you appointment went

This is a good reminder for all that we should use the time immediately after surgery, when the restriction is the most evident, to form new habits and better behavior patterns. Not just small meal planning and eating but exercise, Water intake, and supplementation.

bougie is a unit of measure not a tool

This is a good reminder for all that we should use the time immediately after surgery, when the restriction is the most evident, to form new habits and better behavior patterns. Not just small meal planning and eating but exercise, Water intake, and supplementation.

2big, this very good advice, it's a time to really get it all together. I got to say though for me the first six months, maybe even 7 I was holier than thou on what I should and should not be eating.

SnowDaisy I'm curious how you appointment went

I met with the surgeon and he flipped past the question of the boughie but he is not a fan of the sleeve anyway.

He stayed on the subject of why I should never have got the sleeve in the first place...I had a hernia prior to my original op and apparently having a hiatal hernia is now a contraindications of having a sleeve with tricare. Plus I already had reflux disease, gastritis and this is also a reason not to have the sleeve.

So I'm afraid I didn't really get a lot of time to ask questions...

I did the breath test for h pylori and a blood test...the breath test cam back negative for the h pylori bacteria but the blood work came back with very border line type 2 diabetes.

I have some other health issues that might preclude me from the bypass so I am sitting on hot bricks right now.

Xx

bougie is a unit of measure not a tool

Uhhh ... no its not:

http://dictionary.reference.com/browse/bougie?s=t

The 34Fr or 34F part is the unit of measure, meaning 32 french, which is the unit of measure.

bougie is a unit of measure not a tool

Uhhh ... no its not:

http://dictionary.reference.com/browse/bougie?s=t

The 34Fr or 34F part is the unit of measure, meaning 32 french, which is the unit of measure.

Well most definitely a "tool" for the "measurement" where the surgeon is concerned...but "restriction" is what I considered "my tool".

A Reliable Study

http://www.bariatricnews.net/?q=news/1197/sleeve-gastrectomy-best-practices-published

I would like to draw attention to:

Surgical technique

The panel achieved consensus on the technical aspects of the performance of LSG, which were summarised as:

Sizing the sleeve - in addition to it being important when performing LSG to use a bougie to size the sleeve (100%), the optimal bougie size is 32F–36F (87%). The panel believed that using a bougie <32F might increase complications significantly and that using a bougie >36F could lead to the lack of long-term restriction and possible dilation of the sleeve, resulting in failure of weight loss or long-term weight regain. In addition, invaginating the staple line with sutures might result in temporary or permanent reduction of the lumen size (83%), depending on the suture type used (absorbable versus nonabsorbable).

Staple heights and firings - consensus was achieved for some points including that it is not appropriate to use staples with a closed height less than that of a blue load (1.5mm) on any part of a sleeve gastrectomy (81%). Although panellists voted against this as they did not agree that anything less than a green load should be used. When using buttressing materials (79%) and when resecting the antrum, the surgeon should never use any staple with a closed height less than that of a green load (2.0mm) (87%), because the gastric antrum wall is the thickest part of the stomach.

Mobilisation – it is important to completely mobilise the fundus before transection (96%), otherwise the surgeon could miss a hiatal hernia and leave behind too much stomach, decreasing the restrictive component of the operation.

Great thread (again)

okay here is a picture that shows differences in bougie size. Let's say the difference between the biggest and smallest is 1 tablespoon. And you decided to make up the difference with the highest calorie thing you could find which would be 1 tbsp of butter I'm guessing? So you know, extra 102 calories compared to your smaller bougie counterpart.

It would take you 35 days of eating 1 extra tbsp of butter for you to gain a real pound. I have a hard time believing bougie's impact weight loss that much.

Besides, 85% of a larger stomach is still larger than 85% of a smaller stomach so bougie size is not the only thing that impacts capacity. My husband and I were sleeved same day by the same surgeon, same bougie size. As soon as we were on solids, he could hold 4 oz, I could hold 2 oz.

It's much more about behavior than about bougie, IMHO

okay here is a picture that shows differences in bougie size. Let's say the difference between the biggest and smallest is 1 tablespoon. And you decided to make up the difference with the highest calorie thing you could find which would be 1 tbsp of butter I'm guessing? So you know, extra 102 calories compared to your smaller bougie counterpart.

It would take you 35 days of eating 1 extra tbsp of butter for you to gain a real pound. I have a hard time believing bougie's impact weight loss that much.

Besides, 85% of a larger stomach is still larger than 85% of a smaller stomach so bougie size is not the only thing that impacts capacity. My husband and I were sleeved same day by the same surgeon, same bougie size. As soon as we were on solids, he could hold 4 oz, I could hold 2 oz.

It's much more about behavior than about bougie, IMHO

Did you read the study above?

You did not mention the bougie size used on you or your husband.

According to the research a 32f is gold standard to "long term" success. And it would seem that data is now coming in that anything other than a 32 "could" lead to regain.

I use the "could" because yes some people don't use what they have learnt to modify what they eat any more because of lack of restriction.

I respect your opinion that bougie size don't make any difference but I do not agree.

Another angle on this as I see it is, we are all different and the capacity for the stomach to stretch might be more so for some than others.

Xx