How much of your stomach was removed?

[Icantbelieveit 955]

Bougie is a fun word...just throwing that out there. Bougie.

I like the night life....I love to bougie....on the disco rooooouuuund yeahhhhh

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[Dub 9,922]

My Doctor removed 80 % of my stomach!!! I just wanted to see how much was removed on you all?

I think he removed plenty of my stomach tissue but not enough brain matter.......

[audaciousmarie 161]

Bougie is a fun word...just throwing that out there. Bougie.

I know right!..bougie, bougie, bougie

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[gina171 626]

Ok....I admit it......I have no idea what a bougie is, how it is used, and what the size actually represents.

Can someone please enlighten me?

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[NeedaBreak4Me 1,755]

The bougie is a measuring tool in the form of a long, thin, flexible tube. The surgeon uses it as a guide when dividing the stomach.

During surgery, the bougie is put into the mouth and pushed down through the esophagus and stomach to the pylorus. The tube creates a bulge inside the stomach that the surgeon uses to guide the stapler when dividing the stomach. After the sleeve is formed, the bougie is removed from the body.

[gina171 626]

Brilliant explanation, thank you!

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[Cape Crooner 589]

I have no idea, but at 8 months out, I'm hitting restriction after 6-8 ounces of solid food. This is exactly what I wanted.

[VSGAnn2014 12,992]

Pre-op my surgeon told me that he was using a 36 bougie and would reduce my stomach by 85%. But I haven't had any endoscopic imaging done post-op, so I can't confirm the 85% bit.

I've read it's not just the size of the bougie used that determines our new sleeve's efficacy, but our surgeon's skill in using the stapler to shape the sleeve, leaving enough room at the top (below the hiatal valve) and the bottom (above the pyloric valve) and removing all the fundus (stretchy part).

Apparently, my surgeon did a great job. I've not had any complications, never had digestive problems, and never thrown up.

And at 21 months post-op I'm pleased with my sleeve's restriction, which is 8 ounces (max) when I eat Protein, veggies and whole grains.

Also, my appetite is still significantly curbed compared to what it was like pre-op, although not as strongly as it was for the first 3-4 months post-op. So I'd say the ghrelin reduction is still in force for me.

I'm a very happy camper.

[LADYLOVESME 1]

What is a bougie?

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[jaxmom 643]

The bougie is a measuring tool in the form of a long, thin, flexible tube. The surgeon uses it as a guide when dividing the stomach.

During surgery, the bougie is put into the mouth and pushed down through the esophagus and stomach to the pylorus. The tube creates a bulge inside the stomach that the surgeon uses to guide the stapler when dividing the stomach. After the sleeve is formed, the bougie is removed from the body.

Ahhhhhhhhhhhh!!!!!!!! What????! They did what to me??? I could have lived my whole life without knowing this!!

I'm one of those people who when I go to a doctors office I request a room "with the least amount of icky graphic charts." I just can't. I prefer to think I'm stuffed... Like a teddy bear... Or possibly have a center like a fancy boxed chocolate- thick peanut buttery goodness inside me. Maybe raspberry jam. Yep.

I know some of you are shaking your heads but really, this life of denial has worked just great for me. I've had so many surgeries (knee replacement, foot, back, lap band now sleeve) and I have an impressive thick folder of X-rays to show for it. It's all freaks me out. I do like the word bougie though and French bougie sounds downright awesome.. Kinda like a donut!

"I'll have a croissant and 2 French bougies to go please."

Ummmmm.... Donut...

(That was Homer Simpson, not me. My inner voice says Ummmm.... Mango salsa and a glass of Pinot griot...)

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[4MRB4PHOTO 3,899]

Ok....I admit it......I have no idea what a bougie is, how it is used, and what the size actually represents.

Can someone please enlighten me?

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Here is an article I posted before and a spreadsheet I created for bougie sizes:

Sleeve Gastrectomy – Does Size Matter?

by Kimberly Taylor on August 21, 2013 · Comments | Weight Loss Surgery

The gastric sleeve procedure has quickly become one of the most common types of weight loss surgery, jumping from obscurity to importance in only a few years.

Despite it’s newfound popularity among patients and surgeons, there are many technical aspects of the procedure including bougie size that remain controversial.

What is a Bougie?

The bougie (prounounced BOO-zhee) is a measuring tool in the form of a long, thin, flexible tube. The surgeon uses it as a guide when dividing the stomach.

During surgery, the bougie is put into the mouth and pushed down through the esophagus and stomach to the pylorus. The tube creates a bulge inside the stomach that the surgeon uses to guide the stapler when dividing the stomach. After the sleeve is formed, the bougie is removed from the body.

Bougies comes in a range of sizes that are identified by a unit of measurement called a French. 1 French is equal to 0.333mm (1/3 mm) and is abbreviated as F, Fr or FR. For reference, a 40F bougie measures about 1/2 inch (40F x 0.333mm = 13.32mm, converted to inches is 1/2″).

Standard bougie sizes in the United States range from 32-50F. The bougie size is not the same as stomach size, although it does influence the size of the sleeve.

Generally, the smaller the bougie, the smaller the new stomach size, but the same size bougie does not always create the same size stomach. The finished sleeve size is determined by how close the stapler gets to the guide and whether the surgeon oversews the staple line and if so, by how much.

While the gastric sleeve is now widely accepted as a primary bariatric procedure, there is not yet unanimous agreement on an ideal bougie size. The decision is trying to find the size that will provide the safest results with the most amount of weight loss.

With a smaller bougie size, the smaller the sleeve and greater the restriction, but greater the risk of leak and stricture rate.

A stricture is an excessively narrow section that develops when scar tissue grows and interferes with the normal movement of food and liquids into the stomach. It can cause upper abdominal pain after eating and chronic vomiting or regurgitation of undigested food. Symptoms usually start in the first 6 weeks after surgery. Strictures are very uncommon, but surgery is required to remedy the situation.

If a larger bougie size is used, the sleeve will be larger and the operation safer, but the concern is that it may not produce enough weight loss.

2008 Study

A study in 2008 found that a bougie size of 40F compared with 60F did not result in significantly greater weight loss in the short term.

Comparing 40F versus 60F:

At 6 months, the excess weight loss was 38.8% versus 40.6%.

At 12 months, the excess weight loss was 51.9% versus 45.4%.

(Study: Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2008 Jul-Aug;4(4):528-33. doi: 10.1016/j.soard.2008.03.245.)

2013 Study

In a 2013 study, researchers wanted to find out if there is an ideal bougie size. To do this, they did a search of medical literature published in the last 5 years and analyzed 32 publications involving 4,999 patients.

What they found:

The use of bougies 40F and larger had a leak rate of 0.92% and excess weight loss of 69.2%.

The use of bougies smaller than 40F had a leak rate of 2.67% and excess weight loss of 60.7%.

The results show that larger sizing bougies had a lower incidence of leaks with no change in weight loss. The researchers call for further studies before a decision is made on optimal bougies size, but recommend caution in using the smallest bougie possible because the risks may outweigh the benefits.

(Study: The Effects of Bougie Caliber on Leaks and Excess Weight Loss Following Laparoscopic Sleeve Gastrectomy. Is There an Ideal Bougie Size? Obes Surg. 2013 Aug 3. [Epub ahead of print])

2012 Surgeon Survey

According to a 2012 survey of surgeons experienced in sleeve gastrectomy, the bougie size used ranged from 32F to 50F, with the most common size being 36F (used by 32% of surgeons surveyed). Studies show that the procedure is relatively safe, but there are still many variations in bougie size.

(Study: Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. Obes Surg. 2013 Aug 4. [Epub ahead of print])

Bougie Size

Bougie size is based on patient input, height, weight, and surgeon technique. The bougie size is typically smaller when the procedure is performed as a stand-alone procedure (32-50F) rather than part of the duodenal switch (50-60F).

Depending on the bougie size used by the surgeon, the new stomach size will be about 60-80% smaller after surgery. The average stomach holds 30-40 ounces, or roughly 4-6 cups per meal. After surgery, a small meal of 1/2 cup to 1-1/2 cups will fill the new stomach pouch. The sleeve will stretch somewhat from the surgery size, but will get no where near the size of the original stomach.

If you are planning to undergo the sleeve gastrectomy procedure, make sure you discuss the bougie size with your surgeon during the pre-op process. It is important that you understand the rationale for your surgeon’s recommendation and to feel comfortable with the size of your post-op stomach.

While bougie size is a consideration, healthy weight loss will ultimately depend on following a reduced-calorie, nutrient-rich diet. The sleeve will help reduce hunger and limit food intake, but it is up to you to choose the foods and liquids that you put into your body.

I made a quick EXCEL spreadsheet converting the size to mm and inches based upon the formula.

Note: Per this article, the surgeon's techniques contribute to the overall size ("...how close the stapler is to the guide...", "...whether they oversew"..., etc.)

Bougie Size mm Inches

32 10.66 0.42

33 10.99 0.43

34 11.32 0.45

35 11.66 0.46

36 11.99 0.47

37 12.32 0.49

38 12.65 0.50

39 12.99 0.51

40 13.32 0.52

41 13.65 0.54

42 13.99 0.55

43 14.32 0.56

44 14.65 0.58

45 14.99 0.59

46 15.32 0.60

47 15.65 0.62

48 15.98 0.63

49 16.32 0.64

50 16.65 0.66

Edited May 29, 2016 by 4MRB4PHOTO

[LisaMergs 2,854]

I'm just an inquiring mind- what ever possessed you to create a spread sheet for bougie sizes?

As a bypass patient, I'm happy to know my pouch was left the size of a golf ball. Approximately. Good enough for me.

[NeedaBreak4Me 1,755]

The bougie is a measuring tool in the form of a long, thin, flexible tube. The surgeon uses it as a guide when dividing the stomach.

During surgery, the bougie is put into the mouth and pushed down through the esophagus and stomach to the pylorus. The tube creates a bulge inside the stomach that the surgeon uses to guide the stapler when dividing the stomach. After the sleeve is formed, the bougie is removed from the body.

Ahhhhhhhhhhhh!!!!!!!! What????! They did what to me??? I could have lived my whole life without knowing this!!

I'm one of those people who when I go to a doctors office I request a room "with the least amount of icky graphic charts." I just can't. I prefer to think I'm stuffed... Like a teddy bear... Or possibly have a center like a fancy boxed chocolate- thick peanut buttery goodness inside me. Maybe raspberry jam. Yep.

I know some of you are shaking your heads but really, this life of denial has worked just great for me. I've had so many surgeries (knee replacement, foot, back, lap band now sleeve) and I have an impressive thick folder of X-rays to show for it. It's all freaks me out. I do like the word bougie though and French bougie sounds downright awesome.. Kinda like a donut!

"I'll have a croissant and 2 French bougies to go please."

Ummmmm.... Donut...

(That was Homer Simpson, not me. My inner voice says Ummmm.... Mango salsa and a glass of Pinot griot...)

Sent from my iPhone using the BariatricPal App

Beware of the bougie man *evil laugh*

Sorry i didn't mean to freak you out... it is little scary to think all these things are done to you and you have no recollection of it.... i remember nothing... gotta love the drugs they give you

[LipstickLady 25,682]

Bougie bougie bougie!

If you go into the bathroom and say it three times while spinning in a circle, the bougie man will appear and scoop your eyes out. Just a head's up!

This is my favorite bougie chart:

[NeedaBreak4Me 1,755]

Damn it... i wanted to be a sharpie pen... but im a boring felt tip... least the sharpie is permanent and doesn't leak

So yes @lipsticklady... i think pens are a suitable to reflect our sleeve size lol

No wait... i am a sharpie... my stupid phobe cut off some of the pic! Woohoo!

Edited May 29, 2016 by AussieGirl81