I had my final appt with the surgeon today and one of my questions was the bougie size, he said he uses a 38. I didn't say anything bc I still had a long list of questions and never went back to the bougie topic. I've been thinking about it all evening and I'm really disappointed...I was hoping for at least a 32 or 34. I KNOW there is barely a difference, but every little bit counts to me. Before I sound selfish let me explain why it concerns me so much. For one, I'm self pay and I know I will NEVER get this opportunity again, so a revision is out of the question down the road. Second, I've known 2 people who needed a revision, and it wasn't due to them stretching their pouch, it was due to bougie size. Now I'm wondering if I need to try to make one more quick appt with him before surgery next week to discuss my concern about bougie size...or if I should just let it go and let him do what he thinks is best.

I had a 38. I was worried about it too but ultimately I decided I knew nothing about it and had to trust my surgeon. If you are that worried, my surgeon said he would do whatever size I wanted but I just wasn't comfortable telling him how to do his job. Lol But yes, I had the same thoughts too.

So I asked my surgeon about bougie size too. She said that bougie size is irrelevant if they find that the curvature of your stomach dictates another size. Meaning that they can go in with size 32, 34, 38 whatever, they still have to gauge how much of an offset from the bougie based upon your stomach shape to maintain a certain boundary for your lower stomach valve (sorry don't have the name of that valve in my head at the moment). That if they ignore your specific physiometry (sp?) it can lead to strictures and other serious problems. So he may go in with a 32 and your stomach allows for a close trim and match to 32, or they may go in with a 32 and have to cut away from the bougie to maintain that areas shape and you are closer to a 38. Maybe your doc says 38 because he will make a decision for smaller bougie once he looks at your stomach in real time?

I hope I explained that clearly - but definitely talk to your surgeon... Maybe he has a different reason for his decision...

Unless it is a 60, it doesn't matter, really! The difference between a 32 and a 38 is so minimal. It will not hinder your success and will reduce your chances of complications. Don't worry about it.

My surgeon uses a 32 and oversews, so it doesn't get much tighter! I'm only 3 months out with outstanding restriction, but It should loosen up at. 6-12 months from what I hear.

What is this "Bougie size"? Is it the size of your pouch? Thanks.

What is this "Bougie size"? Is it the size of your pouch? Thanks.

Yes, please explain " bougie size".

Bougie / boughie means "candle" in French. "F or FR/Fr" following a bougie size=French

Its just a guide / tube that your surgeon uses to butt the stapler up against, when forming your VSG. The closer s/he gets to the guide the 'tighter' the sleeve is.

During surgery the bougie is inserted into your mouth down your throat, towards the end of yer stomach where it meets the pylorus valve.

Someone else on this forum posted this picture a few months ago that I found helpful. It gives you a visual of how big these different sized tools are. There really isn't much of a difference between them. Remember, smaller isn't always better. There are plenty of stories on this forum of people having stomachs made so restricted that they can't take in any food or throw it up. Your surgeon is the expert, not you. I would suggest you ask him why he would use one size over another.

For those of you asking what a bougie is - its the long thin tool thy put down your esophagus and into your stomach to help guide them where to cut.

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Edited March 26, 201412 yr by Bluesea71

Someone else on this forum posted this picture a few months ago that I found helpful. It gives you a visual of how big these different sized tools are. There really isn't much of a difference between them. Remember, smaller isn't always better. There are plenty of stories on this forum of people having stomachs made so restricted that they can't take in any food or throw it up. Your surgeon is the expert, not you. I would suggest you ask him why he would use one size over another. <br><br><br><br><br> For those of you asking what a bougie is - its the long thin tool thy put down your esophagus and into your stomach to help guide them where to cut. <br><br><br><br><br><br><br> attachment=42773::]

Yikes good visual. I considered inquiring with my surgeon on boogie size but ur right she's the SME not me. I totally trust her. Thanks for posting.

^{So is the bougie removed...hmm looks like I need to do more research!}

So is the bougie removed...hmm looks like I need to do more research!

Yes, it is removed. It is just a tool they put in the stomach and the tool they use to cut/staple the stomach butts against it on the outside. If you look under other things I've posted on this site, I actually posted a video of the actual surgery. I didn't find it gross and found it informative to know exactly what they would be doing surgically The procedure actually didn't look that difficult! It helped ease my nerves.

Edited March 27, 201412 yr by Bluesea71

I had no idea what a bougie was. My doctor never mentioned it. This link helps explain it. http://www.nationalbariatriclink.org/bariatric-blog/gastric-sleeve-surgery-whats-your-bougie-size/

Most of the people I have spoken with don't even discuss the Bougie size with their doctor. I know I didn't. But it doesn't really matter... the doctor uses what ever size they need to use....and we will lose weight regardless of what size they have used. I'm more concerned with what foods to eat and how much....as that is what causes the weight loss.

I have asked two surgeons about this and both say it is totally irrelevant. The difference between what most bariatric surgeons use now is so minute as to be negligible. That tool serves more as a guide than a final sleeve size since the anatomy of each individual is not identical. If my current pattern of slower weight loss continues, even though I indulge more often than not, I will be in a position of losing too much weight. The difference is your consistent use of new lessons learned.