Aceves bougie

[Rosebud2 26]

Nina just told me he makes a 36 but oversews it down to a 34.

I couldn't find the thread that was talking about bougie sizes.

[WASaBubbleButt 41]

Nina just told me he makes a 36 but oversews it down to a 34.

I couldn't find the thread that was talking about bougie sizes.

It's not really the size of the bougie that matters, it's the technique. A TJ doctor uses a 32F but her patients can eat an entire chicken breast three weeks post op. I am at the one year point and I can't eat half that.

It really doesn't matter what the bougie size is, it's all technique.

[Rosebud2 26]

Good to know.

[MacMadame 81]

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It really doesn't matter what the bougie size is, it's all technique.

Eh, it's a little of both. The thing is, it takes a while to get good at sleeves. That TJ doc is very inexperienced, for example. But even surgeons with good technique find their patients have regain issues if the boughie gets big enough.

Btw, I promised to ask my doc last night whether he was planning to switch to a 36f and he said NEVER! (Just like that. Made me laugh because it's so him.) So that patient must have misunderstood.

Personally, I can't see there being a big difference between a 32 and a 34 (including getting to 34 by oversewing) and if one surgeon finds he gets better results with one than the other, well, we pick our surgeons for their results, right? I'm not going to question 2f if the results are there.

OTOH, there are clearly surgeons who are *afraid* to use a small enough boughie. (You can tell this by their reasons for why they use bigger.) It takes skill to get down in the 30s because you are working on a very small stomach with a very long staple line and not all surgeons have the skill or the confidence.

Personally, I would never go to a surgeon who used a 40 f or higher and, from what I've seen, they aren't getting the results that the surgeons who use 32-36 f are getting.

[WASaBubbleButt 41]

Eh, it's a little of both. The thing is, it takes a while to get good at sleeves. That TJ doc is very inexperienced, for example. But even surgeons with good technique find their patients have regain issues if the boughie gets big enough.

No, it really isn't. The bougie is a guide. There is less than a millimeter of difference in bougie sizes. Not all 32s are alike..

Personally, I can't see there being a big difference between a 32 and a 34 (including getting to 34 by oversewing) and if one surgeon finds he gets better results with one than the other, well, we pick our surgeons for their results, right? I'm not going to question 2f if the results are there.

I have a 32F stomach and I can see a difference of people who have a 48F but there is no difference in 32-38 in the non scientific test we did on another board. Everyone can eat about the same.

OTOH, there are clearly surgeons who are *afraid* to use a small enough boughie. (You can tell this by their reasons for why they use bigger.) It takes skill to get down in the 30s because you are working on a very small stomach with a very long staple line and not all surgeons have the skill or the confidence.

Agreed, between the mega bougie and the lack of technique you CAN tell the difference in someone who hasn't done many sleeves, like Pompa.

[MacMadame 81]

No, it really isn't. The bougie is a guide. There is less than a millimeter of difference in bougie sizes. Not all 32s are alike..

I'm taking about 32 vs. 48, not 32 vs 34. There is plenty of clinical data that you need to remove enough stomach to have success. One study found you have to remove at least 500cc. No matter what your technique, you can't do that with a 48 f or larger because, no matter how tight you butt up against the boughie, you can't get past a certain point.

To us lay people, a ml seems small, but at our support group meeting this week my surgeon told us "10 ml is huge" when it comes to weigh loss and regain. The 5 year data from LapSF shows a 20% difference in weight loss between when they used a 48 f and a 32 f. That's a BIG difference.

Sure, someone can use a 32 f and make huge sleeves by not pushing up against the boughie tight enough. That's why you have to also look at the surgeon's track record. But you can't use a 48 f and make a tiny sleeve no matter how good your technique is.

[WASaBubbleButt 41]

I'm taking about 32 vs. 48, not 32 vs 34. There is plenty of clinical data that you need to remove enough stomach to have success. One study found you have to remove at least 500cc. No matter what your technique, you can't do that with a 48 f or larger because, no matter how tight you butt up against the boughie, you can't get past a certain point.

We are changing topics here. I'm referring to technique, you are now referring to actual size.

To us lay people, a ml seems small, but at our support group meeting this week my surgeon told us "10 ml is huge" when it comes to weigh loss and regain. The 5 year data from LapSF shows a 20% difference in weight loss between when they used a 48 f and a 32 f. That's a BIG difference.

In this procedure 10mm is huge, it's a huge difference. Of course the difference between a 32 and 48 is going to be significant, it's the difference of 5.09mm.

Again, we started off communicating about one issue and now it's drifted.

Sure, someone can use a 32 f and make huge sleeves by not pushing up against the boughie tight enough. That's why you have to also look at the surgeon's track record. But you can't use a 48 f and make a tiny sleeve no matter how good your technique is.

Who are you arguing with? Who made this claim?

[MacMadame 81]

We are changing topics here. I'm referring to technique, you are now referring to actual size.

But you said it was ALL technique and size doesn't matter.

If someone is lurking who is contemplating a surgeon uses a 48 f, I don't want them thinking "oh, it doesn't matter, as long as he has good technique." It most certainly does matter once you get past a certain size.

[WASaBubbleButt 41]

But you said it was ALL technique and size doesn't matter.

If someone is lurking who is contemplating a surgeon uses a 48 f, I don't want them thinking "oh, it doesn't matter, as long as he has good technique." It most certainly does matter once you get past a certain size.

True, once you get beyond a certain size but for the 95% of surgeons who use standard size bougies size is not an issue. It's technique.

People get so wrapped up in bougie size and they are looking at the wrong thing here. I'll bet you that Pompa's 32F is bigger than a more experienced doctors 48F.