Will Doctor Let Me Have Input Into Bougie Size

Bbinder2002
on 1/28/15 5:40 am

I am interested in a bougie size 40F or larger based on the below 2013 student that NIH did.  Does anyone have thoughts on this study?

 

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.

Stricture rate was also higher in bougie less than 40F

(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])

 

Gwen M.
on 1/28/15 5:58 am
VSG on 03/13/14

He shouldn't. I'm sure he is comfortable performing surgery with the size he uses and does it for a reason. 

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

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frisco
on 1/28/15 6:19 am

Smaller sleeves are harder to make and must be shaped properly.

Smaller sleeves have a higher % of WL and lower percentage of regain..... in general. Smaller capacity, less food.

Larger sleeves can stretch more than a smaller one because more stretchy tissue is retained.

Can anyone do well with any size sleeve?..... yes, many have done well with larger sleeves.

As you can tell from forums like this that there is definitely a range of eventual capacity from 3oz to 12-16oz.

WLS is more about long term keeping the weight off that you lost vs. the initial WL.....

Whatever surgeon you go to, it is more accurate to find out the individual surgeons stats, which would include.

- deaths

- leak rate

- other complications

- average percentage of EWL

- average regain at 5 years

And it really helps if your goals are inline with with their results.

Also read back posts on the revision forum here on OH.

Great question and keep doing your research !!!

frisco

SW 338lbs. GW 175lbs. Goal in 11 months. CW 148lbs. WL 190lbs.

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BrendaRae
on 1/28/15 8:44 pm
VSG on 01/13/15

Before  my surgery, i asked my surgeon what size he used. I was relieved that he said a 40fb. Basically  the  same  reason ,  less issues with strictures , less leak rates and basically  about the same weight  loss. I have had no problems  getting 100 oz of fluids in a day. I'm 2 weeks post op and 16 lbs down.

      

        

    

    
Bella_Fein
on 1/28/15 10:35 pm, edited 1/28/15 10:40 pm - TX
VSG on 02/18/13

It may have been reckless of me, but I never asked my surgeon until afterwards. He is the best surgeon in my area and I trusted him. If I wanted surgery he was my only option as well. My relentless curiosity is the only reason I asked in the end. I was determined to make this work no matter the size. At this point I don't remember if he said 34 or 36 but I know it was one of the two and he says he does it a little loose.

 

In reality the bougie is just a guide and your stomach size will be different depending on how loose or tight your surgeon makes it. A 40 can easily be as small as a loose 32. Technique, knowledge and a steady hand is what will get you good results. Overall statistics do you no good; you need to know your doctor's individual statistics. ALSO, no one wants to fail, but some people choose to not succeed by choosing bad options and going back to old habits.

 

Diameters of bougie in inches:

32F = .40"
34F = .425"
36F = .45"
38F = .476"
40F = .5"
46F = .576"
60F = .75"

 

See: VSG BOUGIE SIZES

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