What size sleeve produces best results with no complications?

Just curious how well folks do with different sleeve sizes and what, if any, complications do they experience. Would love to hear about your experience Presently debating DS or sleeve surgery.

i have a lose 34f and have had no problems so far but im only 4 weeks out , the sizes of the diffrent sleeves used for vsg are not that much different , the size for the ds can be almost twice the size as those used for the vsg

 the 32f have a slightly higher leak rate and people have more problems eating and drinking at first , they all end up about the same size 1 cup at around 1 year or so ,  I can now eat 1/2 cup of softer solid food (meat balls, chicken, eggs)and im eating around 600 Cal a day 65-75 gm protein

What does a 34f equal in ounces ? Thanks for the info. I, too, had heard that a smaller sleeve can result in complications but too large can result in less weight loss.

Just a side note....there is NO VSG that comes with a zero complication rate.

 

Anne

Great question........

My answer is that the VSG is not a standardized procedure. Surgeries, goals and outcomes can be all over the place.

Now days it's not really about the bougie size number because there are many variables on how that sizing tool is used.

The best way is to go by individual surgeons statistics, with the major key points being sleeve capacity, % of EWL and complication rate.

When I researched the VSG I picked a surgeon with a high success rate working with the SMO with the least amount of complications. My surgeon makes a very small sleeve with the concentration on shape and technique for proper food flow. He probably has done among the most VSG's with a complication rate that is less than a half of one percent when the national average is between 2-4% depending on who you listen to. He also does this with his patients commonly losing and maintaining in the 90%EWL average.

frisco

Is there a specific site I can go to find physician success rates etc in NC for the sleeve?

No. 

It's a jungle out there and we're totally on our own. You have to call the all surgeons you are interested in, ask them their complication rate, and hope they don't lie to you. (Most don't but there is no way to tell.)

Some things to watch out for:

-I've never had anyone die "on the table" or "in the ICU"

First of all, almost no one dies in the OR and almost no one even ends up in the ICU, let alone dies there. You want to know if anyone has died PERIOD. Generally, if they die with 30 days of surgery it's counted against the surgeon.

-My complication rate is ____

But what does that mean? You want a leak rate under 1%. Period. There is absolutely no reason for it to be higher. If it's higher... run. If they won't tell you their leak rate but lump it in with ALL complications including stuff like severe nausea (which sometimes just happens for no good reason), run!

-My success rate is _____

Okay. But what does that mean. If they can't tell you, that's not good. When they do tell you, make sure it matches your definition. If they say "70% of my patients maintain a lost of 50% of excess body weight at 5 years out" that's actually pretty good. But if you want better than that, find out how many do better than that and how much help the office is going to be to get you there.

Other things to ask about: what is the aftercare program like. How much is included in the fees. What fees are there that are not covered by insurance.

Another thing to watch out for: programs that don't want to answer your questions. You are an adult. If you want to know what bougie size he uses (99% are he's), then you have a right to know even if he thinks it doesn't matter. It's your body and your life.

Thanks so much! I really appreciate your guiding me as this can be a tad overwhelming. I'm going to include all of these questions in my interview.  I really appreciate your help :)  

So true to what Frisco said...other factors are really more important to consider. I believe my surgeon usually does a 40 or 42 sewn tight. I'm 17 months out and usually can't do more than 3-4 oz of meat and maybe 1/2 cup of veggies.

My co-worker had the same surgeon as I did, about 6 months prior to mine. He had a nerve caught in the staple line and when he woke up in recovery he was in severe pain, where they had to go back in and fix it. He had severe nausea for months and I think he still may experience some sickness sometimes now, over 2 years out. He kinda has a big capacity and eats sandwiches and other junk often and has gained unfortunately.

Me on the other hand, I've had no complications or sickness at all. Never. No complaints. Of course when I choose to eat slider foods, I don't get full and I suffer later in water weight gain.

Complications/size-capacity aren't necessarily relative...

The size that your surgeon has the most experience and succes with and the one that you are going to commit to :)

I am in the 40's, made it to goal no problem, and maintenance is no problem thus far.  No side effects, great labs... perfect scenario!