Choosing Bougie Size

[tomd74 0]

Do doctors discuss bougie size with you or do they each have a certain size they prefer to use ? Or, put another way, do they allow the patient to be involved in deciding how small or large to make the “new stomach”?

[The Greater Fool 1,932]

You are literally putting your life in the hands of your Doc. Proceed with caution.

I've never heard of patients being consulted on such things, but that doesn't mean much as I haven't been all that interested in current WLS practices.

I honestly can't figure how a patient can have any sort of meaningful input on this. The Doc has performed hundreds if not thousands of surgeries and have been intimately involved in follow-up of said surgeries. They would have the information and experience with their surgery that no one else possesses.

I can only relate this to my work. I'm a well regarded professional at what I do, I've been doing it for 45 years. My clients hire me because of my education and experience. Like most professionals, I love being second guessed. Nothing tells me to drop a client quicker than for them to solicit my expertise only to ignore it because they read something by a random person on the internet.

If you don't trust your Doc to make the best choices, then hire one you will trust. [Rhetorical 'you' throughout here]

Good luck,

Tek

[Sassafras1 63]

My Doc was very specific in mentioning it was a "one size fits all" when it comes to the sleeve. It wasn't based on BMI or the weight you wanted to lose.

[MaybeMeow 129]

As far as Bypass goes my surgeon and I spoke at length about how much bowel he would bypass. He did a short or 100cm bypass on me when most do 150-200cm I'm told. I preferred this as I'd come in for a sleeve with 65 pounds to lose and he convinced me with my history of GERD the Bypass would be better. I was concerned about malabsorption and dumping and he said he found the shorter bypasses had far less dumping and said the bloodwork of his patients was usually better with the shorter bypass as well. He did say the weight loss was sometimes slower with the shorter bypass. And mine definitely is with a 37 pound loss at 4.5 months post op. But I'm ok with it.

So... not stomach size but bowel bypass... yes!

[Arabesque 6,420]

I was just told he’d take about 80%. The ‘about’ related to the size of my original stomach. If I’d stretched my tummy over the years, he’d take a little more. If my stomach was more usual size he might take a little less. I presumed it was more about getting my tummy to a specific size in regards to what it would hold post surgery - about 200mls I think???

[Foxbins 625]

I think each surgeon becomes comfortable with their procedure. It also appears from what I've read that some surgeons staple close to the bougie, some a little looser, and some do an overstitch over the staple line that tightens things. Research has shown that generally bougie sizes smaller than 32F have higher incidences of complications, and sizes larger than 42 have poorer weight loss outcomes, but really if your surgeon is experienced I would not really focus on bougie size. You can ask, but it's not the only factor contributing to success.

[RickM 1,747]

I don't know what size bougie my surgeon used, never discussed it with him, nor do I care. It is just a guide for the surgeon to use, and as noted above, some may sew things tighter or looser around it. The important thing is the end result, so I would concentrate there. Overall, I have seen on these forums people mentioning having bougies typically between 32 and 40, and based upon the reported weight loss from them all, it is really hard to correlate results from stated bougie size. Further, based upon personal experience, my wife has a huge sleeve, likely a size 56-60 which is common for the DS that she has, and yet her meal size is very similar to my own with a typical mid 30s bougie. Go figure..

In short, there are a lot more important things to worry about than bougie size (like, how many sleeves has your prospective surgeon performed - how he uses that tool, and how well practiced he is with it is a lot more important than what specific tool he is using.)