Strange Question Lol.

[xlr8ahead 40]

Just wondering does any one know what size bougie or calibration they had to size the stomach.as some are bigger than others .and wondered if they used like a smaller one on a low bmi an larger on a higher bmi?. Just curious.

[Lissa 2,631]

Bougie size is pretty much irrelevant. There is very little difference between the smallest and largest bougies. Some folks have more volume because they are taller and therefore often have longer sleeves than shorter people, but the bougie doesn't really give you extra room. Here's a picture that shows the difference in sizes.

[mattr2 32]

I was a low BMI-er going in at 32 and wondered the same thing. I wanted a larger Boogie, a 40f but the dr pretty much ignored me. He said he was doing 32f only but would make it "loose."

Who know how much difference it will make in the end since it really does matter how the dr sees it up, but the simple math can't be ignored. The larger the bougie the larger the sleeve. You can't control the length of you stomach and that is the biggest factor as previously mentioned.

Personally, I was really hoping for the 40f but ohh well. I'm only 2 days post op, leaving back to the states today. It's going to be interesting learning to swallow again. There is no room down there for much Water let alone food. Patience and time will make all the difference.

[seelessofme 63]

What is a boogie

[Wheetsin 714]

What is a boogie

Boogie is a dance.

Bougie is a sized tube that many VSG surgeons use a guideline to size our remaining stomachs.

[O.T.R. sleever 3,386]

What is a boogie

It is the tool they place in your stomach during surgery to form your new stomach.

[Wheetsin 714]

Bougie size is pretty much irrelevant. There is very little difference between the smallest and largest bougies. Some folks have more volume because they are taller and therefore often have longer sleeves than shorter people, but the bougie doesn't really give you extra room. Here's a picture that shows the difference in sizes.

Agreed! The difference between the smallest bougie used for this procedure, and the largest, is something in the area of less than 1 tbl over the course of the entire stomach. The only real correlation I've seen with bougie size to - anything, really - is the incidence of stricture.

Here's a post I've made previously, it might help:

I think when measured out the capacity difference between the smallest bougie commonly used (I'm guessing 32) and largest (guessing 54) is about a teaspoon. I calculated it out once but right now I'm not remembering the exact number. As I've said before, none of us got MO on a teaspoon. So in terms of capacity, bougie size is basically a moot point.

A 32 Fr bougie has an inner diameter of... (get out calculator)... 0.4". A 40 Fr bougie is 0.5". That's a whopping one tenth of an inch difference. But also remember that bougie size and sleeve size are not the exact same.

The long term stats of % EWL losses between bougie sizes (at least the ones with long term results available) are virtually the same, if not exactly the same.

Surgeons used to (and maybe still do) follow the logic that a smaller bougie = smaller sleeve = better weightloss. Now they're seeing trends that smaller bougie = greater leak risk, and greater incidence of post-op GERD. The threshhold between higher incidence and no higher incidence seems to be the difference between a 32 and 34 Fr bougie, respectively. But even that's a bit arbitrary, and going to depend to a degree on the patient. My surgeon will not use anything smaller than a 34.

The average stomach is about 12" long and about 6" wide, with a standard capacity of about a quart. Tall people have longer stomachs? I think it's debatable. It's all just genetics and genetics favor proportion, mostly for survival, but we see a lot of exceptions every day. And I've seen a lot more studies refuting it than supporting it. ~1950 there was a study of 126 cadaver stomachs, and there was no significant correlation between stomach size and height, nor stomach size and weight, nor stomach size and gender:

And from 2002:

*shrug* Dunno. I know that I'm taller than most females here, have a Fr 34, and am eating less than most other posted quantities I pay attention to.

[Butterthebean 8,146]

I think the "math" is so inconsequential, that it is irrelevant. The surgeon should and will use whatever size bougie he/she deems medically necessary.

And Lissa, I thought I remembered reading on this forum sometime back that someone posted a link to an article stating height had no bearing on the length of the organs, including the stomach. Do you recall that? Maybe I'm misremembering.

[KS Fort Worth 86]

LISSA -

Thanks for the photo! It's irrelevant for me at this point, but in my pre-surgery research I never saw that photo. It really helps with perspective, seeing them held in a hand.

For those interested, Dr. Kim uses an endoscope during his sleeves, operated by his assistant surgeon. He uses that as the gauge as well as for seeing things from the inside, but I don't know the bougie equivalent.

[mattr2 32]

I have to respectfully disagree Bean. But what do I know.

If you increase the diameter of cylinder, the volume is greatly changed. Think of the difference in surface area of a tv. Do you notice the difference between a 32" and a 40" TV? Then add another depth element to it and the volume difference is that much greater.

All we can do is trust our surgeon that they make the correct choice for us. I had read that larger bougie surgeries experience less complications and less acid reflux effects, but also may have a higher change of stretching. I am sure the surgeons have waaaaaaaay more data points to support their reasons for doing what they do that we forum trolls have to consider.

[O.T.R. sleever 3,386]

One more thing to consider, the bougie is just a guide. Different surgeons have different techniques. Surgeon A may use a 32 bougie and staple 1/2" from it, whereas surgeon B may use a 40 and staple tightly against it.

This shows where 2 different bougie sizes could very easily create the same diameter sleeve. Or even a larger sleeve with a smaller bougie.

[mattr2 32]

+1

Correct. This is exactly what my surgeon said.

[Kalimomof3 613]

idk what happened to my comment?

[Rootman 1,101]

Guys, the Bougie is a tool used by the surgeon. Its a tube shaped long flexible rod that's pushed down your throat and into the stomach and through the pyloric valve into the very first part of the intestines. It is held there through the stapling procedure in order to provide a guide for the surgeon to use - and also to prevent them from accidentally stapling the stomach closed. Because once the surgeon pulls the trigger on the stapler the excess is cut off and it's PERMANENTLY SEVERED.

YES, the difference in sizes is slight, but the surgeon is not pushing the staple tool up tight up against the Bougie inside the stomach, they generally just follow a line from where the stomach drops away from the pyloric junction to where it joins back to the esophagus. The Bougie sits there loosely, not jammed tight against the staple line.

So NO the Bougie sizes don't mean a whole lot as the sleeve is formed so loosely. When all is said and done the difference in capacity of a sleeve loosely formed around a 32F isn't much smaller than around a 40F, maybe as previously stated a few teaspoons difference in capacity.

You are more at to get a smaller sleeve by just being genetically disposed to having a shorter stomach than by the Bougie size and even then we're talking teaspoons size difference not cubic inches difference.

[Lissa 2,631]

I think the "math" is so inconsequential, that it is irrelevant. The surgeon should and will use whatever size bougie he/she deems medically necessary.

And Lissa, I thought I remembered reading on this forum sometime back that someone posted a link to an article that stating height had no bearing on the length of the organs, including the stomach. Do you recall that? Maybe I'm misremembering.

Bean, I try to keep up with the research to a point and I don't recall the article. Of course, I've had a couple of months of being in my own little world due to some family drama, so I may have missed it, too. I'll look for it.