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The following study (dated March 2016) showed that there was no difference in %EWL after 1 year for patients with 32-Fr bougie versus 40-Fr bougie.

Laparoscopic sleeve gastrectomy for morbid obesity: does bougie size matter

Conclusion: LSG is a safe and effective operation for treatment of morbid obesity and obesity-related comorbidities with significant short-term weight loss and an acceptable complication rate. Bougie size does not affect short-term outcomes. We need to extend our study to determine the effect of the bougie size on the long-term outcomes.

Note that the optimal size of the bougie remains controversial. The aim of this study was to evaluate the first year outcome of LSG using two different sizes of bougies.

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The ASMBS website also cites a study that showed no difference in short-term outcomes between 34-Fr bougie and 60-Fr bougie in patients whose BMI is less than 60.

https://www.soard.org/article/S1550-7289(15)00620-6/abstract

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On 11/20/2018 at 12:52 PM, marieg said:

The smaller the bougie the More restriction you have.thus a more effective tool.

Please cite any scientific studies that show a smaller bougie is more effective. I have not found any that confirm your statement.

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2 minutes ago, MarinaGirl said:

Please cite any scientific studies that show a smaller bougie is more effective. I have not found any that confirm your statement.

Hi

Its not scientific.i have several friends that have gotten a 32fr bougie in mexico vs the standard 40 bougie most NY Drs do.it seems that my friends with the smaller bougie ate better able to reach their goal weight and are having an easier time maintaining 3 years post sleeve.

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But there are several studies showing optimal size to be 34-35 French. Less than that, could give you tighter control but also increased risk of complication or dehisance, and nobody desires that!

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I believe in scientific evidence versus anecdotal statements concerning very few people (i.e. small sample size).

Correlation does not imply causation.

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3 hours ago, marieg said:

Hi

Its not scientific.i have several friends that have gotten a 32fr bougie in Mexico vs the standard 40 bougie most NY Drs do.it seems that my friends with the smaller bougie ate better able to reach their goal weight and are having an easier time maintaining 3 years post sleeve.

Perhaps your friends who self-paid for their surgery in Mexico are more compliant at eating less post-op than the ones that had it covered by insurance in NY because they paid more money out-of-pocket. Or the ones who went to MX had lower BMI so less to lose, or do not suffer from Binge Eating Disorder, or didn’t go back to their old eating habits, or drink less alcohol, or lots of other reasons that could result in better weight loss & maintenance. Just because their bougie was smaller doesn’t mean that’s why they’ve maintained their weight loss compared to others.

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My surgeon used an endoscope rather than a bougie - no idea what size it was. I do know I feel excellent restriction, and am sticking to the nutritional recommendations, and am meeting my goals. I think that's what's important.

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On 11/25/2018 at 9:41 PM, marieg said:

Hi

Its not scientific.i have several friends that have gotten a 32fr bougie in Mexico vs the standard 40 bougie most NY Drs do.it seems that my friends with the smaller bougie ate better able to reach their goal weight and are having an easier time maintaining 3 years post sleeve.

You can totally eat around the sleeves bougie size, so don't count on it doing all the work for you. A better assessment would be to look at overall success rates of the surgeon / pending disciplinary actions/ malpractice suits, etc.

Bougie size won't matter much if you are suffering from constant complications because of a poorly executive surgery.

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