What is the right bougie size to get a tight sleeve?

jarabacoagirl
on 4/13/12 3:00 am
VSG on 12/17/12
The surgern I'm probably going with uses a 32 F Bougie.  Is that the right size for a tight sleeve? 

HW 302 lbs SW  279.8 lbs.  CW  193.8 lbs   MFP Jarabacoagirl  Preop diets 22.2 lbs, 1st month 21.2 lbs, 2nd month 14.6 lbs,  3rd month 11.2 lbs, 4th month 7 lbs, 5th month 7 lbs, 6th month 6.8 lbs, 7th month 5.2 lbs, 8th month 4.4 lbs 9 and 10th months slowed down didn't record exactly

108.2 lbs lost from highest weight!

 (86.2 lbs of that was lost since surgery date)

Mom4Jazz
on 4/13/12 4:06 am
Now there's a controversial question. 32g is a common small size. But surgeon technique has as much to do with the tightness of the sleeve as bougie size.

Does the surgeon staple tight to the bougie or loose? Do they oversew? Do they start close to or far from the valves at the pylorus and esophagus (we've seen sleeves that looked like barbells there was so much stretchy tissue at the top and bottom)?

My surgeon used a 40f on me. I still cannot eat 2 oz of lean meat. Takes me 1/2 an hour or more to finish a small cup of yogurt. Have to break a Quest bar into two servings. At one year, my sleeve is much tighter than a lot of folks who had 32f sleeves. We have seen 32f sleeves made so loose at the top and bottom that they can eat 4 oz a month pre-op.

It's good to ask the questions, but your best way of judging is to see how your surgeon's existing sleeve patients are doing. 

Highest weight: 335 lbs, BMI 50.9
Pre-op weight: 319 lbs, BMI 48.5
Current range: 140-144, BMI 21.3 - 22

175+ lbs lost, maintaining since February 2012

jarabacoagirl
on 4/13/12 4:15 am
VSG on 12/17/12
I'm leaning toward having surgery with Dr. Alvarez in Mexico.  He has a lot of good reviews.  Im' self pay so i have to get it done in Mexico probably.  He has a video on it but I still don't really understand it.  So does that mean the higher the number the smaller or tighter the sleeve?
http://www.youtube.com/watch?v=g3G4dSmJUro

HW 302 lbs SW  279.8 lbs.  CW  193.8 lbs   MFP Jarabacoagirl  Preop diets 22.2 lbs, 1st month 21.2 lbs, 2nd month 14.6 lbs,  3rd month 11.2 lbs, 4th month 7 lbs, 5th month 7 lbs, 6th month 6.8 lbs, 7th month 5.2 lbs, 8th month 4.4 lbs 9 and 10th months slowed down didn't record exactly

108.2 lbs lost from highest weight!

 (86.2 lbs of that was lost since surgery date)

Mom4Jazz
on 4/13/12 4:23 am
No, in theory the smaller the number the tighter the sleeve so a 32f should be smaller than a 40f. In practice as I said, bougie is far from the only factor. That's why my 40f, which should in theory be bigger than most 32fs is actually smaller than a lot of them.

I know there are some Dr. Alvarez patients on the sleeve board. Why not post a query there with his name in the topic line and ask them if they feel their sleeves are nice and tight?

Highest weight: 335 lbs, BMI 50.9
Pre-op weight: 319 lbs, BMI 48.5
Current range: 140-144, BMI 21.3 - 22

175+ lbs lost, maintaining since February 2012

jarabacoagirl
on 4/13/12 4:25 am
VSG on 12/17/12
Good idea!  Thank you! 

HW 302 lbs SW  279.8 lbs.  CW  193.8 lbs   MFP Jarabacoagirl  Preop diets 22.2 lbs, 1st month 21.2 lbs, 2nd month 14.6 lbs,  3rd month 11.2 lbs, 4th month 7 lbs, 5th month 7 lbs, 6th month 6.8 lbs, 7th month 5.2 lbs, 8th month 4.4 lbs 9 and 10th months slowed down didn't record exactly

108.2 lbs lost from highest weight!

 (86.2 lbs of that was lost since surgery date)

Maureen K.
on 4/13/12 9:05 am
 Well said I am coming up on 4 years out and my surgeon used a 48f really one the biggest I have seen on the boards yet I can eat less than some who's surgeon used a 32 so definitely surgeon technique and also the length of your stomach also plays in as well so best wishes on your journey it is awesome you will love it 

SW - 223  CW- 130 GW- 140  Start Sz 18 Current Sz 4 Ht. 5'6"
 BA- LBL/TT 11/3/09

   

  
amyl0528
on 4/13/12 10:00 am
Phew makes me feel better that other people have larger bougie's with great success.  I just got back from my pre op and my surgeon uses a a 40F.  He did say he over sews and sews tight to the bougie (if that makes sense, lol).  I was starting to get a little concerned reading all these 32-34f's etc.
   
VSG Surgery May 1, 2012
MsBatt
on 4/14/12 12:58 pm
Something to think about is the relationship between the size of the Sleeve and the likelihood of strictures and/or acid reflux. The tighter the Sleeve, the more likely these problems seem to be.

If you're afraid that portion control isn't going to give you all the help you need, have you considered going with the full DS? Same Sleeved stomach, plus an intestinal bypass to give permanent malabsorption of calories, and the very BEST long-term, maintained weight-loss stats.
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