Anyone Size 48 Bougie?

My doc. says he has to see the size of the stomach then makes his decision---long slender stomach, very wide stomach, etc.
btw: I love reading the posts when you and terrij start 'discussing' : it is quite entertaining--I think you both enjoy it too!  Best of luck with whatever you decide!!!

My doctor was the same.  I have no idea what size he used on me.  I left it up to his professional judgment ...its what I paid him for.  He aims to make the stomachs about 60cc I believe but said, when I asked, that he has to look at the individule case so there is no exact answer.  At my followup I will ask him more

Hey Missy, shouldn't your profile say VSG, not VBG?

ok now how did that happen?  It used to say VSG, I think

"I have read that choosing the right size bougie is part of the proper planning. "

I don't know where you read that, but very few doctors allow you to pick your boughie size. They have a size they use and their reasons for using it and you either agree with them or you don't and go somewhere else. Sometimes you can talk them into 1 size higher -- say a 34 instead of a 32 -- but it's not like you can demand a 48 when they believe that 48 is too big and you'll be sorry later.

Btw, there is another study on boughie size where patients were followed for five years that shows that there is a difference in success rates once you get to 2 years out. The conclusion of that study is that "A removed gastric volume of <500 cc seems to be a predictor of failure in treatment or early weight regain."

http://www.ncbi.nlm.nih.gov/pubmed/18098398?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel

My surgeon is the one who gave the presentation that people are talking about. He and his partner have been doing this surgery for 7 years now and they have done as much as anyone ... more than most. They found regain to be a problem when they were using the 48 f and switched to the 32 f and are getting much better results. I find the results of a couple hundred patients with each size over several years to be pretty compelling.

That's the article I'm trying to get the full text of today!  The chart in Cirangle's presentation shows much more detailed information from that study.  I'd love to read the whole thing.

The conclusion of that study is that "A removed gastric volume of <500 cc seems to be a predictor of failure in treatment or early weight regain."

You mean that if my stomach is that big before surgery then a person is more likely to fail?

I think that it means that if you don't remove at least 500cc, the surgery won't be effective.

But since I haven't read the whole study yet, I'm not sure.

Yes, that's what it means.

They studied 3 groups. One had their stomachs cut with no calibrater, which resulted in large sleeve volumes. One had a calibration tube of 44 f and one had a calibration tube of 32 f.

Something my surgeon also said in one of our seminar/support group meetings is that the shape of the sleeve -- long and cylindrical -- means our stomach empties slower than those who have RnY with the egg/walnut shaped pouch and that this can contribute to a great feeling of fullness and may explain why our weight loss is as good as theirs even though they have malabsorption and we don't.

Not that this relates directly to boughie size, but it does indirectly. Plus I just thought it was interesting.

Marshall - what you are going through is pretty typical for a pre-op. It's just so hard to imagine being full/satisfied on so little food. In fact, I don't think I've ever felt "satisfied" pre-op no matter how much food I ate. It's just so different post-op and I think at some point you have to trust the process and your surgeon.

Marshall

What size did you end up getting? I am a 42.

Hugs,B