Gastric Sleeve vs Gastric Bypass

Deciding between surgeries like a gastric sleeve vs gastric bypass requires some detailed knowledge and a good understanding of the lifelong commitments required by the patient as well as the surgical techniques that are involved.

Gastric Sleeve surgery is often used as a first stage surgery prior to a full Gastric Bypass. The Gastric Sleeve is used on patients that are considered too high risk or are just too ill to undergo the stress of a bypass.

The Gastric Sleeve surgery removes a large section of the actual stomach itself. The part of the stomach that is surgically removed is the upper stomach, which is responsible for producing the hunger hormone, Ghrelin. This surgery helps the patient lose weight twofold, the new size of the stomach is restrictive and you will feel full very fast. Two, you will have less hunger issues as your body is not producing the hormone which tells your body that it is hungry. Combining these two powerful processes has increasingly made the Gastric Sleeve an increasingly popular stand alone surgery.

The Gastric Bypass procedure, the most common being the Roux-en-Y bypass . In a full bypass your stomach is also reduced in size by surgically making a small pocket in the upper part of the stomach with surgical staples or by installing a restrictive device which is essentially a plastic band. The reduced stomach is then surgically routed to the middle portion of your small intestine. This causes your food to pass through the intestinal tract too quickly to absorb all the calories and nutrients, causing weight loss. This rerouting of the digestive process is a much more invasive and arduous surgery than a Gastric Sleeve and has a higher rate of complications such as nutritional deficiencies and possibilities of developing ulcers.

The Gastric Sleeve vs. Gastric Bypass Comparison

Deciding between the procedures requires that you fully understand the fundamental differences in the surgical process used for each.

With the bypass, your surgeon will create an new outlet for your stomach (think it of it as putting in a new exit door) After creating the new outlet in your stomach, the surgeon will remove the unused portion of the small intestine and route the remaining small intestine to the new opening he created(stoma).

With the Gastric Sleeve your stomach will still be surgically reduced in size but your digestive track is not rerouted, or bypassed at all. This has the distinct advantage of not causing malabsorptive problems. Nutritional deficiencies are not an issue as all the stomach remains intact, you just feel full when eating, and are only able to eat reduced portions. Your entire digestive system remains the same and you just use it at a reduced rate.

Gastric Banding vs. Gastric Sleeve

A Gastric Sleeve can be substituted by a Lap Band (adjustable band) instead of a surgery to remove a portion of the stomach. The band will restrict the quantity of food you can eat at one sitting by basically choking the entrance to the stomach itself. This is the only easily reversible gastric procedure and has the advantage of having the least complications. Gastric Banding does however, require frequent visits to your doctor for maintenance. The band is regularly tightened or loosened by injections into the band via a connection in your lower abdomen. The Gastric Band is often used in conjunction with a bypass surgery. 

Which weight loss surgery is right for me?

The ultimate decision on which is better for you, a Gastric Bypass vs Gastric Sleeve surgery should be made between you and your health practitioner. I think you can make your preference clear by being comfortable with an informed understanding of the process involved. A basic medical understanding of weight loss surgery will go a long way in having a quality consultation with your surgeon about your decision.

Weight Loss Surgery Comparison Chart

Gastric Bypass Surgery Gastric Sleeve Surgery
Produces the greatest weight loss but has the most potential complications and risks Produces less weight loss than a full bypass but has less complications
Nutritional deficiencies a real issue as the digestive track is heavily rerouted In surgery The digestive track is unaltered and Nutritional deficiencies are normally avoided
Mortality rate is 1 in 350 patients apx. Mortality rate is 1 in 1000 apx.
More expensive, normally almost double. Less expensive if you are out of pocket patient (self pay)
Lifestyle changes are more severe More regular lifestyle after procedure
Bypass can be postponed in stages, you could try less invasive surgeries first Gastric Sleeve can be a first stage surgery and if you still need it you can get the Bypass at a later date.



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