What volume fits into a gastric sleeve stomach after sleeve gastrectomy?
The maximum tolerated volume (MTV) or gastric volume reflects the size of the bougie* used during surgery and how long ago the surgery was performed.
Straight after surgery, the volume is predictably small but within quite a short period of time, the sleeved stomach stretches.
The sleeve's gastric volume increases as the months go by and appears to stabilise about 2 years after surgery. The sleeve's volume increases by a massive 50% at 12 months after surgery. This highlights the need to take full advantage of the early months after surgery when the stomach-sleeve is still small and responsive to maximise results.
At the OSAANZ Conference in 2012, Catherine Jarman reported at 2 years after sleeving, a 250 ml MTV gastric capacity with 40 F bougie compared with 330 ml MTV with 50 F bougie. That's quite a difference in capacity. It helps explain why some people with sleeves can consume a lot more than other people can a few years out from surgery.
Why does the sleeve stretch out? We don't know for sure and I can only be theoretical about this. The ordinary stomach is a very stretchy organ that stretches and shrinks to suit the the amount of food and drink it receives. Research suggests that either the sleeve-stomach doesn't shrink back fully after it stretches or the body is attempting to restore the stomach's capacity to a more 'normal' volume through some kind of adaptive process.
Bottom line? Do not over-stress the sleeve. Do not over-fill it. Learn your limits early and don't keep pushing them.
*a bougie is the calibration device that surgeons use to work out how big to make your new stomach. Basically it is like a tube that is placed inside the stomach. The surgeon then snugs a staple-cutter up against the outside wall of the stomach and tube while stapling and cutting away the remaining stomach. F is a size reference - the smaller the F, the smaller the sleeved stomach's capacity. A too small a bougie may increase complications (leaks, strictures) whilst a too large a bougie could lead to lack of restriction and possible dilation of the sleeve and so failure of weight loss (or risk of early weight regain). The optimal bougie size is said to be 32-36 F but this is best discussed with your own surgeon.