BTW..Bougie size

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.

(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])

2012 Surgeon Survey

According to a 2012 survey of surgeons experienced in sleeve gastrectomy, the bougie size used ranged from 32F to 50F, with the most common size being 36F (used by 32% of surgeons surveyed). Studies show that the procedure is relatively safe, but there are still many variations in bougie size.

(Study: Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. Obes Surg. 2013 Aug 4. [Epub ahead of print])

Bougie Size

Bougie size is based on patient input, height, weight, and surgeon technique. The bougie size is typically smaller when the procedure is performed as a stand-alone procedure (32-50F) rather than part of the duodenal switch (50-60F).

Depending on the bougie size used by the surgeon, the new stomach size will be about 60-80% smaller after surgery. The average stomach holds 30-40 ounces, or roughly 4-6 cups per meal. After surgery, a small meal of 1/2 cup to 1-1/2 cups will fill the new stomach pouch. The sleeve will stretch somewhat from the surgery size, but will get no where near the size of the original stomach.

If you are planning to undergo the sleeve gastrectomy procedure, make sure you discuss the bougie size with your surgeon during the pre-op process. It is important that you understand the rationale for your surgeon’s recommendation and to feel comfortable with the size of your post-op stomach.

While bougie size is a consideration, healthy weight loss will ultimately depend on following a reduced-calorie, nutrient-rich diet. The sleeve will help reduce hunger and limit food intake, but it is up to you to choose the foods and liquids that you put into your body.

Thanks for finding and posting this research for us.  This is very helpful.

Thanks soooo much for this info!!!

Thanks. I think our posts are crossing in the mail  Disregard my previous post. I tried to delete it. It provides the same info you just added. Gracias!

I don't know what size bougie my doc used, if indeed he used one at all (some don't - it's just a tool), but my stomach was about 2.5 oz at time of surgery, which given my height (stomach length generally correlates to stomach length) probably equates to a 32-36. My wife, on the other hand, had a 4 oz stomach at surgery time, which at her height probably works out to a 56-60 - a typical size for the DS that she has. Yet, contrary to some of the things you may hear here - that if you don't have a tight 32 you will be destined to scarf 20 oz steaks - her functional capacity after ten years might be 20% more than mine on a good day; certainly not a major difference given the "huge" differences at the starting point.

In general, I'm less concerned about which tool is being used as how it is being used - as we often see in life, quality trumps quantity (or raw numbers.)

My sleeve is  40fr, and my weight loss has been very successful.  I lost 225 pounds in about 18 months, and I'm having no trouble maintaining at a normal BMI.  I'm almost 2 years post op, and I still only eat about 7 ounces per meal.  So I wouldn't say my sleeve is too big.  Success has more to do with the commitment you make to following your plan and changing your eating habits. 

Best wishes,

Carol 

I don't remember the exact size but I know my surgeon takes the conservative approach.  He said that at most I might have trouble losing the last 5 lbs which he was okay with.  I'm small - 5'0" and had no trouble losing or getting the last 5 lbs off - the last 1.6 was a little bit of a challenge.  Go with your surgeon's comfort zone.

Also, you are talking the rest of your life not just the losing time period with the sleeve

My operative report says a bougie of 'approximately' 38Fr was used. I am very comfortable now eating about 4 oz of dense protein. No room for anything else. If I want vegies I need to reduce the protein to 3 oz. It worked for me. I am also quite short - 5ft0 - so I imagine my stomach is not that long. I had no issues at all post op in terms of getting in my liquids, protein, tolerance, etc. Haven't vomited or had nausea in years, before and after surgery and no discomfort of any kind. Just lost all my excess weight and am maintaining... so yeah, whatever my doc did worked for me.

My surgeon used a 42fr.  I was surprised, but I think it might be because he re-sews / over sews the sleeve.

Psren13, nothing wrong with asking questions. You would never want to blindly walk into a surgical procedure (major surgery) without asking questions and finding out as much as you possible about what will be happening to you and your body!