48 fr Bougie?

[Morgandobes 0]

Thats what my doc says he uses.

He says he sews loosely to the left of this, guess he is very

conservative.

Ack! should I be concerned that this will be waaaay to big for me to

see the big weight losses other people are seeing here on the board?

Anyone else have this size bougie?

Thanks,

Lisa

[lmmore 0]

Sounds too big to me, but I am no expert.

[Tiffykins 673]

I've shared this is a couple of other threads.

The pens are NOT the size your stomach will be once it is healed. This is just a comparison.

If you haven't seen this, I found this on OH, and think it'll give you an idea of honestly how minimal difference in a 32 and 40 really is.

Just a visual to offer more pictures of how minimal the difference is between the sizes your concerned about.

Here is a fabulous link for bougies. It physically lists every size of bougies, with the millimeter measurements.

Scroll to pages 3 and 5 to see the table of reference for bougie sizes.

http://www.medovations.com/pdf/Esoph...Dilatation.pdf

You can pull up the PDF file, and scroll to page 5. It shows that the difference between a 32Fr, and a 48Fr is only 6mm.

I know it seems huge, but in the grand scheme of things, surgical technique is going to play a bigger role in the actual size of your stomach post-healing. Dissecting all of the fundus is crucial.

[Morgandobes 0]

Thanks Again Tiffykins, you are an awesome resource.

It just seems so HUGE...lol.

I am hoping to not have to do a lot of 'dieting' after this surgery, and

dont want to have to go in for another revision if I can eat too much is all.

Sigh..

Thanks for the link,

:-)

Lisa

(Who has a surgery date of may 27th!)

[Morgandobes 0]

FYI..he says he uses the larger one because a smaller diameter can cause a 'stricture' near the bottom curve of the stomach.

I havent really heard about that on this board, but I guess being a doc he might

be better connected than I am

Lisa

[mommaof4yoopers 3]

the visual was very helpful, i really need to find out the size my doc used. i haven't a clue!

[goodlife 3]

I "think" my surgeon used a 34

[SParkle 4]

Mine said he would use a 32.

It does sound like a huge size, but Tiffs pictures are a good reference to show the differences - which in reality aren't much between the sizes.

Maybe think about comparing the size 48 to your current stomach - so it'll still be a lot smaller. Was he adamant about using this size or could you ask him to go smaller?

[Lillie24 2]

Yep... theres another good question for the pre op appointment

[stcyt 15]

My surgen uses a 32 F but I asked him to go bigger since i was starting with a low bmi. He ended up using a 38 and so far I'm pretty happy but its early to tell. Like tiff says.... it probably doesn't matter much but it made me feel better.

I don't know a lot about this but I thought I read somewhere that they used to use 50-60 fr and weight regain was an issue? I might have that wrong but it would be worth looking into. I bet tiffikins knows the real stroy here.

stacey

[Robbiehage 1]

You should write a VSG guide Tif, seriously.

[goodlife 3]

My surgen uses a 32 F but I asked him to go bigger since i was starting with a low bmi. He ended up using a 38 and so far I'm pretty happy but its early to tell. Like tiff says.... it probably doesn't matter much but it made me feel better.

I don't know a lot about this but I thought I read somewhere that they used to use 50-60 fr and weight regain was an issue? I might have that wrong but it would be worth looking into. I bet tiffikins knows the real stroy here.

stacey

yep I read that too...I think that with that much larger size they were leaving too much of the stretchy part of the stomach in and regain was a big issue because it was just stretching out.

And yeah I bet Tiff does know all the deets. lol

[ouroborous 519]

I believe Dr. Landerholm uses a 38.

Thanks for that PDF, Tiffykins. Very informative, as usual.

[deletedsally 8]

Before I had my surgery, I took the picture that lines up the pens/markers as a comparison for bougie size to my pre-op appointment and discussed it with my surgeon. I did not want him to use a bougie that would interfere with my ability to swallow, cause foods to get stuck, or increases the likelihood of GERD. He said that he typically uses a 40 because that offers enough restriction with less problems than the smaller bougie sizes. I appreciated the fact that he was willing to discuss the options. What may be equally important is the size of the pouch that is created when your stomach is reduced. Until my MD explained it, I was afraid that the bic pen represented the entire size of the remaining stomach. That is not true. As I understand it, the bougie size is the amount of restriction of the sleeve above a small pouch and different surgeons seem to have their personal preferences on how much stomach to remove and how large of a pouch to leave.

[Tiffykins 673]

My surgen uses a 32 F but I asked him to go bigger since i was starting with a low bmi. He ended up using a 38 and so far I'm pretty happy but its early to tell. Like tiff says.... it probably doesn't matter much but it made me feel better.

I don't know a lot about this but I thought I read somewhere that they used to use 50-60 fr and weight regain was an issue? I might have that wrong but it would be worth looking into. I bet tiffikins knows the real stroy here.

stacey

You read correctly. When the DS was first started and up until probably the last decade, surgeons used large bougies. When the sleeve was performed as a stand alone procedure early on, they did see more bounce back regain than they have in recent years. Also, with the DS, it seems that patients could consume much quantities of food per day and even though they have the "switch", that doesn't mean they always got to goal, or didn't regain some weight. Not dissecting the fundus completely is where stretching comes into play from everything I've read.

None of the WLS beat white carbs, and junk food. There's a few "failed" DS patients that have posted trying to get back on track or to goal. It isn't really failed(in my opinion), it's just battling obesity even with the assistance of the "Platinum" standard of WLS.