VSG Maintenance Group
Question about Dr. C and his bougie technique
I've read soooo much about Dr. C and how he saw better results with smaller bougies, plus something about the way he cuts the stomach off or something like that, that ensures greater success for his patients.
My doctor (who is the only game in town) told me that he uses a 38f. This was about 18 months ago. I don't know if that has changed. I don't know if he oversews or anything else I've read about Dr. C doing. He did say that he won't go smaller than 38f because of it being too small and getting kinked up or something. I've tried googling to see if Dr. C has anything published about what he does and why it is so successful, to no avail.
I only have 6 pounds left so expect to be seeing my MD soon (I hope, I hope, I hope). I would like to take some kind of documentation with me to discuss his technique with him. Then I think that being possessed of a massive ego, this doctor might not be interested in what another, far more experienced doctor with great success, might have to say.
Thoughts? Suggestions?
Thanks!
My doctor (who is the only game in town) told me that he uses a 38f. This was about 18 months ago. I don't know if that has changed. I don't know if he oversews or anything else I've read about Dr. C doing. He did say that he won't go smaller than 38f because of it being too small and getting kinked up or something. I've tried googling to see if Dr. C has anything published about what he does and why it is so successful, to no avail.
I only have 6 pounds left so expect to be seeing my MD soon (I hope, I hope, I hope). I would like to take some kind of documentation with me to discuss his technique with him. Then I think that being possessed of a massive ego, this doctor might not be interested in what another, far more experienced doctor with great success, might have to say.
Thoughts? Suggestions?
Thanks!
No heaven will not ever Heaven be
Unless my cats are there to welcome me.
~Author Unknown
That does not sound like a good idea at all.......
If you want a small sleeve.....you need to find a surgeon that does them.
Smaller sleeves are harder to make so it's not a good idea to push a surgeon into something they are not comfortable with.
They will probably just be offended you are bringing another surgeons specs in.....and your off on the wrong foot....
frisco
SW 338lbs. GW 175lbs. Goal in 11 months. CW 148lbs. WL 190lbs.
" To eat is a necessity, but to eat intelligently is an art "
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Dr. Paul Cirangle
Yeah, I thought that might be the case. I'm pretty much stuck with whatever Dr. Crooms will do. Even though I live in the capital of the state of Florida, he is the only surgeon in town who does the VSG and my insurance only utilizes doctors in this county.
My only other choice would be to drive 3-4 hours away to Jacksonville, Orlando or Tampa and self pay.
Thanks for your input, Frisco!
My only other choice would be to drive 3-4 hours away to Jacksonville, Orlando or Tampa and self pay.
Thanks for your input, Frisco!
No heaven will not ever Heaven be
Unless my cats are there to welcome me.
~Author Unknown
Dr. Cirangle is probably not as successful as people think. There is a lot of talk about how his numbers are biased.
He does not include all of his patients in those numbers, only the ones who come in for follow up appointments, and those of course tend to be the more successful ones. He is supposed to make a "reasonable attempt" to contact ALL patients before publishing numbers but he does not.
I have not changed my phone or address since surgery, yet no one from his office has ever asked me for my current weight. I have heard this from multiple other patients that didn't hit "goal". We just don't get included in his numbers.
So, take his "success" with a grain of salt. Sure he has a lot of success stories, but like other surgeons he also has a lot of other stories that get swept under the rug.
(I don't mean to imply that I am unhappy with my sleeve or my surgery, just need to relay the factual information that I am not a "major success" and not included in his statistics)
He does not include all of his patients in those numbers, only the ones who come in for follow up appointments, and those of course tend to be the more successful ones. He is supposed to make a "reasonable attempt" to contact ALL patients before publishing numbers but he does not.
I have not changed my phone or address since surgery, yet no one from his office has ever asked me for my current weight. I have heard this from multiple other patients that didn't hit "goal". We just don't get included in his numbers.
So, take his "success" with a grain of salt. Sure he has a lot of success stories, but like other surgeons he also has a lot of other stories that get swept under the rug.
(I don't mean to imply that I am unhappy with my sleeve or my surgery, just need to relay the factual information that I am not a "major success" and not included in his statistics)
Height: 5'7" Join US On The VSG Maintenance Group Forum!!
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Thanks, Jen. My concern is that Dr. Crooms may only lose the 38f as a guide loosely, thus making it actually bigger than 38f. I don't know if he oversews either.
It is quite possible that when I do see him, he may do all of the things I want him to do, in which case I will have been fretting for nothing. The main thing is that I just want to be as prepared as possible in that respect when I do go see him.
It is quite possible that when I do see him, he may do all of the things I want him to do, in which case I will have been fretting for nothing. The main thing is that I just want to be as prepared as possible in that respect when I do go see him.
No heaven will not ever Heaven be
Unless my cats are there to welcome me.
~Author Unknown
My surgeon uses a larger Bougie than Dr. C. does as well, and I've exceeded his goal for me, reached a BMI of 22, and I'm only 4 pounds from my personal "stretch" goal. I think I'd have exceeded my goal if I hadn't let some bad habits creep in over the past few months, but that's on me, not my surgeon.
Now, does every sleeve patient of my surgeon achieve these results? No, I don't think so. I've been very motivated, very strict with a low-carb diet ****il the last few weeks, and that's impacted my weight loss), and I've become an avid exerciser. But it can be done. Sleeve size helps, but it's not the be-all, end-all of your success story, in my opinion. And, I didn't have to deal with a lot of the struggles tight sleevers seem to experience early out - lots of nauseau, vomiting or extreme discomfort if they eat one bite to many, etc. And, I've had no complications at all.
I think there are pros and cons to a smaller sleeve, and in the end, it's not about your surgeon, it's about what you do with the sleeve he gives you.
Now, does every sleeve patient of my surgeon achieve these results? No, I don't think so. I've been very motivated, very strict with a low-carb diet ****il the last few weeks, and that's impacted my weight loss), and I've become an avid exerciser. But it can be done. Sleeve size helps, but it's not the be-all, end-all of your success story, in my opinion. And, I didn't have to deal with a lot of the struggles tight sleevers seem to experience early out - lots of nauseau, vomiting or extreme discomfort if they eat one bite to many, etc. And, I've had no complications at all.
I think there are pros and cons to a smaller sleeve, and in the end, it's not about your surgeon, it's about what you do with the sleeve he gives you.
I appreciate your response! After over two years of researching the VSG, you'd think I would remind myself lf all this, but I have gotten myself off track worrying about every single thing going right.
Hehe, I'll try very hard not to ask to many stupid questions from the Maintenance Group here after I get my surgery!
Hehe, I'll try very hard not to ask to many stupid questions from the Maintenance Group here after I get my surgery!
No heaven will not ever Heaven be
Unless my cats are there to welcome me.
~Author Unknown
I may be the contrarian here, in that I believe the surgeon technique part is AT LEAST as important as bougie size - how close to the pylorus and esophogeal sphincter they start, how tight to the bougie they staple, etc. That said, it would seem that Dr. Cirangle was also one of the pioneers of those techniques.
We see folks on here who had a 32f bougie but can eat pretty astonishing amounts after a couple of months. I attribute that to surgeon technique.
I have a nice, tight 40f and it remains, at one year, as small as the majority of 32fs I see. Not all, but most. I have big tummy days and tiny tummy days - on a big tummy day I can finish a 2 oz serving of meat...sometimes. On tiny tummy days 1 1/2 oz is a big serving.
If I were you, I'd be very interested in the results your surgeon's patients are getting at say a year out. Is there a support group you can attend and talk to them?
We see folks on here who had a 32f bougie but can eat pretty astonishing amounts after a couple of months. I attribute that to surgeon technique.
I have a nice, tight 40f and it remains, at one year, as small as the majority of 32fs I see. Not all, but most. I have big tummy days and tiny tummy days - on a big tummy day I can finish a 2 oz serving of meat...sometimes. On tiny tummy days 1 1/2 oz is a big serving.
If I were you, I'd be very interested in the results your surgeon's patients are getting at say a year out. Is there a support group you can attend and talk to them?
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
Thanks Mom4,
I will be doing exactly that. It's been about a year and a half since I saw him. Things may have changed, but sometimes I tend to rush ahead and get the cart before the horse.
I am just so focused on doing everything I humanly can to get things to go well for me that I tend to worry at every detail like a dog with a bone.
Thanks again!
Anita
I will be doing exactly that. It's been about a year and a half since I saw him. Things may have changed, but sometimes I tend to rush ahead and get the cart before the horse.
I am just so focused on doing everything I humanly can to get things to go well for me that I tend to worry at every detail like a dog with a bone.
Thanks again!
Anita
No heaven will not ever Heaven be
Unless my cats are there to welcome me.
~Author Unknown
I had my surgery in Celebration (Orlando) with Dr. Kim, self-pay. He uses a 36f Bougie, oversewn. I couldn't be happier. Having said that, there are surgeons in Gainsville and Ocala that might work with your insurance.
The difference between a 32F and 38F bougie is very small. The recent consensus statement released by VSG surgeons on VSG suggests that there's an optimal 'range' of bougie sizes from 32F to 36F. Also, how far they start the cut/staple line from the pyloric valve makes a difference. The further away from the valve, the bigger the 'base' on the sleeve. Studies show that has the advantage of less vomiting and nausea but the disadvantage of larger capacity. A 32F oversewn started further from the valve may have as much capacity as a 40F started closer. It all depends.
The difference in Bougie size shouldn't be your biggest concern. How many sleeves has your surgeon done? What kind of after-care is available? What kind of support groups? Nutritionist?
The difference between a 32F and 38F bougie is very small. The recent consensus statement released by VSG surgeons on VSG suggests that there's an optimal 'range' of bougie sizes from 32F to 36F. Also, how far they start the cut/staple line from the pyloric valve makes a difference. The further away from the valve, the bigger the 'base' on the sleeve. Studies show that has the advantage of less vomiting and nausea but the disadvantage of larger capacity. A 32F oversewn started further from the valve may have as much capacity as a 40F started closer. It all depends.
The difference in Bougie size shouldn't be your biggest concern. How many sleeves has your surgeon done? What kind of after-care is available? What kind of support groups? Nutritionist?
Carolyn (32 lbs lost Pre-op) HW: 291, SW: 259, GW: 129.5, CW: 126.4
Age: 45, Height: 5'2 1/4" , Stretch Goal: 122 
