Is request in volume change of VSG possible?

I had read on the Men's forum that someone had discussed elongating the length of his sleeve with his surgeon.  The basis for elongation were related to height of the person and increased need for fluids.

I was wondering the exact opposite, has anyone spoke to their surgeon about decreasing the size of the sleeve and/or opted for this change with surgeon approval.  I was going to talk to my surgeon about this in 6 weeks, but wanted some feedback.

There are some on this forum who believe you should go to your surgeon and DEMAND that s/he use the smallest bougie (guide) possible.

I'm of the opinion that my surgeon has performed the procedure far more times than I have, and I trust his experience and judgement in making the correct size sleeve for my body.

The person on the mens forum you are referring to may not be properly informed or didn't communicate clearly.....in any case the way your post reads is how I will try to answer.

Sleeve elongation happens when sleeve stretch occurs, it not only gets bigger in diameter, it also can elongate.

Taller people "tend" to have longer stomachs and tend have longer sleeves which means a little more capacity.

Sleeve stretch can only really happen with internal pressure. Constant over eating is usually the main reason. The sleeve can be a very high pressure system if abused.

The only medical/surgical procedure I have ever heard of is a sleeve dilation. This is normally done to open up a narrowing or stricture. It is done with a ballon type device. I have never heard of a procedure that makes a sleeve longer..... which dose not mean it dosen't exist.... just means I've never heard of it.

Most importantly (the way your post reads) is that this person on the mens forum you speak does not know how the pyloric valve works and how it's function is so important to successful sleeve eating. Fluilds should go right through an open pyloric valve. When open the pyloric valve has an opening about the diameter of a dime and when closed it's about the diameter of the head of a ball point pen.

Re-sleeving is an option to tighten things up. That said it's a bit dangerous as the leak chance is higher than a virgin sleeve. And a lot of people that go in for a re-sleeve have stretched the remaining stomach tissue so much the tissue is a lot thinner.

It is always better to get a nice small sleeve from the beginning. They are harder to make without complications and proper food flow but they tend to be better on restriction/capacity in the long run.

frisco

The person that I am referencing had spoke with his surgeon before the initial VSG procedure.  They had both discussed and agreed to the length of the sleeve being longer than normal related to to the patient's potential for dehydration.

I do agree with the forum response that the surgeon should be the arbiter of good judgement.  I trust my surgeon's track record, but was wondering if these concerns have brought up by any of the pre-op surgical candidates in the follow ups before surgery.

Thanks again for the replies, appreciate the feed back.

I work for a healthcare system and my brother is a surgeon.  No surgeon in his right mind is going to let the patient dictate how the sleeve is created.  You can certainly ask about bougie size and the process he uses ie. cutting, stapling, over-stitching.  But the surgeon is going to work with the stomach that you have.  And that means taller people will generally have a "longer" stomach.  

I hope that makes sense! 

My surgeon chose the size of my sleeve based on the upper GI test I had done before surgery. I don't even know what bougie size he used, I trusted him to do what he felt was right for me based on his skill and experience performing this procedure. I am not sure how it is even possible to 'elongate' a stomach while removing part of it during the surgery, that doesn't make sense to my little brain.