1) I’ve read studies showing that smaller bougie sizes (28F-32F) are associated with high leak rates, strictures, and GERD. Sizes above 34F-36F seem to be tolerated better with the same amount of weight loss. Therefore, I’m wondering what size bougie you use?
A: Dr. Ismael Cabrera uses 34 fr bougie in all patients.
2) What is your goal for the final stomach capacity in ounces?
A: The final goal Is between 3 or 4 ounces
3) Do you oversew the staple line?
A: Yes we do with a prolene string.
4) How many sleeves have you performed? Have you had any complications? Leaks? Deaths?
A: Around 2700 and we had 4 wound infections that require curations, we had no leaks, we transfuse blood to 2 patients but no require reoperation. No deaths at this time.
5) I hear it is common for the sleeve to swell after surgery which may lead to nausea and vomiting. Can anything be done prophylactically to prevent this?
A: Yes we use 2 medicines to avoid nausea and sometimes we use steroids very useful in those patients.
6) Do you place patients on blood thinners to prevent pulmonary embolisms?
A: Just in BMI up to 50.
7) I tend to scar very easily and so I am wondering how you close the incisions. Do you use subcuticular suturing that eventually dissolves with Dermabond/glue over the incisions?
A: Yes we use subcuticular absorbable sutures.
8) I’ve never had surgery before but I am worried about post-surgery nausea and vomiting. I have a very low threshold for nausea and easily get nauseated. If possible, can an anti-emetic be given before surgery or even during surgery via IV to prevent nausea after the surgery?
A: Of course we will give you 2 medicines to avoid nausea.
9) How many leak tests are done?
A: Two leak tests. One operative room and the second one the next day after surgery.