A few more reasons to get a good VSG surgeon.

I had Dr. Yatco too, and have also had zero complications! In fact, he's the one who told me about the sleeve in the first place.

Question/Comment

I have been told the bougie size doesn't make that much of a difference.  What would you say is a normal bougie size? Is there such a thing as a normal bougie size? I will be sleeved on 9/29 and I'm only saying this because @ my last support group I asked one of the sleevers what size he had and he said a 40 french and all the others in the class immediately said it doesn't matter.  So Frisco, I was just wondering.......what are you thoughts.  As always you comments/advice are greatly appreciated.

There are going to be plenty of people that tell you it doesn't matter, and maybe to a certain degree it doesn't.  I don't believe it makes a huge difference in the losing stage of the process.  However, the reason I chose to have WLS is because of my desire to MAINTAIN this weight loss, and yes, it does matter a great deal in maintenance.  That doesn't mean that people *****ceived a larger sleeve can't maintain, it just means that all things being equal, it becomes harder and harder for them to do it.  The larger the sleeve, the more it stretches in the long run.  Of course the size of the bougie used is just one aspect of how big your sleeve is going to be, but it is an important one.  Other things to consider is the technique used by the surgeon, in other words, how tight he pulls around the boughie, whether he cuts all the way to the top and bottom of the stomach and other considerations.  In addition to this there is the length of your own stomach to consider, stomachs come in very different lengths.  Then there is the biggest issue of all, how you are going to treat your sleeve.  Will you be compliant?  Will you under-eat the capacity of your sleeve or will you pu**** to the limit?  In the end, your compliance is the big key.  However, it sure is easier to be compliant when you have a small capacity.  I would only want a 32F sleeve and would not get anything much bigger than that.  On the other hand, I would never push any doctor to make a tighter sleeve then he is comfortable making as you could end up with complications if the surgeon doesn't have the proper skill set. Choose your surgeon as if your life depended on it, because your life and your quality of life very well might depend on him.

Could not agree more that a good experienced surgeon is important for this procedure. Mine told us that if the staple line is not completely flat and even,  it can cause a little kink which then causes much nausea. I read a lot of papers my surgeon wrote about why they start and finish the staple line where they do, how they put anesthetic in the gas they inflate you with and then suck it out to minimize post op pain, and other things. I felt like everything possible was done for my comfort and it worked.

but in addition to technique, follow up is very important. Studies show that patients with long term follow up do better overall than those without much. So my surgeon puts a big emphasis on this. Some others do too while others do less. So consider this fact when choosing the surgeon and whether they provide dietician support, are available for questions and the like. It makes a difference. There are many fine surgeons now as this procedure is well on the way to being the best option for many people. Just emphasizes the need to research the heck out of your prosepective surgeon including talking to other patients. Thats what I did here on OH over two years ago and am glad I did.    Diane

I think arguing about bougie size is just silly. As with any type of WLS, the patient has to be compliant and that is the MAIN way to ensure success. I have lots of experience with surgical equipment and I have peronally seen the difference in bougie sizes and they are pretty miniscule. While a 44 is bigger than a 32, it isn't TONS bigger. It is still way smaller than the stomach you did have.

I am glad that so many people are happy with Criangle. Yay, good for you. In all areas of medicine, there are different opinons/schools of thought/practices.... He may be an expert but he isn't the only one and his techniques and methods are not the only ones that are successful.

My doc used a 36f because he has experienced lower complication rates and good long term success with that size. If your chosen doc uses whatever size and has stats to back it up, you trust his judgement, then go with it.

Like I said, being vigilant is the best way to ensure success. I am not an expert on the sleeve and don't feel like I will be one just because I lose weight and keep it off. Follow your program (what ever the program). Chances are a lot of thought, education, and experience went into it!!

Bottom line, eat less calories than you burn.... you will lose weight!

There is controversy amongst the sleeve docs as to what sleeve size works better (if indeed there is a "better".)  It is thought that the larger sleeves are more prone to slower loss and maybe more regain, while the smaller sleeves are more prone to reflux. They really don't know and are waiting for more longer term data to guide them. For now they give it their best shot with what they think is best for an individual patient and with what they are comfortable doing.

 
The point of my post was to share something I just learned......... and it has to do with food getting stuck and acid reflux, twists and strictures.

If you imagine trying to attach a garden hose to a basketball......the easiest place would be where the hose touches the basketball...... Same with the bougie (whatever size) a surgeon has to really work to get the bougie snugged up against the the spine of the stomach.

This effects the flow of food....or more importantly..... why food would get stuck and back up at that narrow point. This also is the perfect recipe for a twist or stricture.

My post was not "Go run to Cirangle" my post was.... "pick a good surgeon"

Go to one that has great Weight Loss Statistic, fewest complications, highest long term success rate and long long term data to back it up.

Why even go through all this if you have a chance of high percentage regain?????

People get to hung up on the initial weight loss.......success is only attained when you have maintained at 3-5 years out

Your body....your choice.....

Just sharing information.... not trying to start a ******g contest.

frisco

The director of bariatric surgery where I had my surgery was at a support meeting recently and was asked about bougie size.  He laughed and said that this must be the new hot topic on the internet.  His opinion – the difference in sizes is so minor as to be insignificant in long-term results.  You either make the lifestyle change that’s necessary to maintain your new weight, or you don’t.  People come back to him claiming that their stomach/pouch (he was talking about both VSG and RNY) had stretched, he’s gone down with the scope, had a look around, and everything is fine.  They’d simply stopped doing the things that had made them successful in the first few years and let all the bad habits slip right back in. 

As we’ve said repeatedly on this board, you can eat around any surgery, and you can eat around any size stomach.

And does anyone willfully choose a bad surgeon?  You have a ton of people here posting from all over the country on a new procedure.  Stop with the it's not a new procedure.  It's new to insurance and acceptance in the Bariatric community.  They will not all have the opportunity to go to someone with 12 years experience but they will choose the best of what is available.  I've never heard anyone say "I want the worst surgeon" or "A mediocre surgeon would be nice" and it is hard to say what is what unless your doctor had high mortality rates.  I come from a family of doctors and it is not always the ones with the most procedures who have been practicing longest who are the 'best'.  sometimes they have been practicing too long and have had too many patients and part of their doctoring skills get diminished IE explaining, talking, reassuring.  Let me say i am not referring to Dr Cirangle, but i think for the most part people want the best they can get, that best is just different depending on cir****tance.  Nobody wants a dog and sometimes even with the best of research, the best doctor, the best cir****tance, you end up with one. You can work toward making it less of a crapshoot, but it's still a crap shoot. it's surgery.

 
True True True !!!!

Make the lifestyle changes.....make the commitment and comply !!!!! Yes Yes Yes........

My surgeon with 10 years of back data on over 1600 VSG's would not laugh nor use the term insignificant.

A bougie ten numbers higher than a 32f (42f) can end up 4x larger.

A properly shaped 32f starts out at around 2oz. capacity and matures to about 4oz

When you look at a 32f bougie and a 42f bougie side by side.....doesn't look like much difference.....like the difference between a Sharpie and a Magic Marker.

A 42f can stretch to up to a 16oz capacity....that's significant !!!!

**Caveat
We have some 42f sleeves on this board that have done well......taking care of your sleeve is another topic that relates to all sleeve sizes.

Dr. Cirangles long term data shows a higher % of regain among his patients with larger bougie sizes.

frisco