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Gastric Sleeve vs Gastric Bypass

Most bariatric surgery statistics are showing that patients are steering away from gastric banding surgery, and opting to choose gastric sleeve surgery and gastric bypass surgery. Every year since 2005 statistics show that gastric sleeve and gastric bypass are being out-chosen for bariatric surgery. Right now gastric bypass accounts for 80% of all the bariatric surgeries in the United States.

Notable Difference

The notable difference between these two surgeries is that gastric bypass provides more expected weight-loss than gastric sleeve. A Rand Corporation study found that patients lose on average 20 pounds more with Roux-en-Y gastric bypass, than with vertical sleeve gastrectomy.

Gastric Sleeve versus Gastric Bypass: Table Comparison

Name:
Gastric Sleeve

RNY Gastric Bypass
Method of Weight Loss Restrictive

  • Reduces Stomach Size and Hunger Hormone Ghrelin
 Restrictive & Malabsorptive

  • New Stomach Created
  • Alters Digestion
Stomach Alterations Stomach size reduced

  • 70-85% of the stomach is removed.
 New Stomach is Created: Stoma.

  • Stomach is bypassed, with a new smaller stomach (stoma) created with intestines.
Changes to Intestine No Change Cut and Bypassed

  • Stoma is connected and rerouted to bypass a large portion of intestines. This reduces absorption of nutrients and calories.
Operating Time
  • 1 to 3 hours
  • 2 hours
Average Hospital Stay
  • 2 to 3 days
  • 2 to 3 days
Time off Work
  • 2 weeks
  • 2 to 3 weeks
Recovery Time
  • 3 weeks
  • 3 months
Pros:
  • No intestinal changes: Less complications and side effects including dumping syndrome
  • Hunger depressed because of reduction in Ghrelin production
  • Life-time Approach to Obesity
  • Simple procedure
  • High Expected Weight Loss, Comparable to Duodenal Switch.
  • Gastric Bypass has been performed hundreds of thousands of times, thus, side effects and complications are known.
Disadvantages
  • Newer surgery with long-term results somewhat unknown
  • Stomach Could Enlarge
  • Requires More Nutritional Supplements and Vitamins – Not as much as gastric bypass
  • Major and complicated surgery with associated risks.
  • Leakage, Bleeding, Vomiting all occur.
  • Daily Supplements and Vitamins Required.
  • Dumping Syndrome is Common.
Surgery Description Long narrow vertical pouch (about 2-3 oz or 60-100cc). Same shape as the duodenal switch pouch but smaller. No intestinal bypass. The VG significantly restricts the volume of food that can be eaten. There is a no malabsorption of nutrients or dumping. Small pouch (about 1/20-30cc) Pouch is connected to the small intestine where food and digestive juices are separated for the first 3 to 5 feet. The RNY significantly restricts the volume of food that can be eaten.
Realistic Expectations
  • Patients can expect to lose 60%-70% of excess weight in about 2 yearst.
  • Long term results not available at this time.
  • Easily converted to Duodenal Switch or Gastric Bypass if needed.
  • Provides mild malabsorption of nutrients.
  • Patients can expect to lose 70% of excess weight.
  • Less effective (patients who loseDoudenal Switch.
Post Surgery Dietary Info:
  • Patient must eat 3 meals a day containing 600-800 calories per day (recommended for the first 24 months) and about 1000-1200 thereafter.
  • There is no dumping or diarrhea.
  • Patients must eat 3 small meals a day.
  • Patients must avoid sugar and fats to prevent Dumping Syndrome.
  • Patients must take vitamin and protein supplements to avoid deficiency (Multivitamin, Calcium, Vitamin B12, and Iron for menstruating women)
Candidate Efficacy
  • VSG is effective for high risk or very high BMI patients (BMI > 60kg/m2) patients as a “first-stage” procedure. Much lower complication rate than the RNY Gastric Bypass or Duodenal Switch due to there being no intestinal bypass performed.
  • Gastric Bypass is effective for patients with a BMI of 35-55 and those with a “sweet tooth.”

Gastric Sleeve Surgery

Gastric Sleeve Surgery is a permanent weight loss surgery that reduces the size of the stomach by as much as 85%. This restriction helps in two ways: first, the smaller stomach capacity helps to make patients feel fuller faster – therefore reducing caloric intake. Secondly, the hunger hormone is reduced, allowing patients to be free of hunger desires.

Gastric Bypass Surgery

Gastric Bypass Surgery is a very powerful weight loss surgery that uses two surgical methods to achieve big weight loss for patients. Gastric Bypass uses restriction and malabsorption to severely reduce caloric intake. Gastric bypass is intended for patients who are suffering from co-morbidities, along with a very debilitating obesity.

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SOURCiS, Inc. (DBA: Mexico Bariatric Center) is a scheduling facilitator. We are not a healthcare provider. The information contained on this site is for educational purposes only and does not constitute medical advice nor creates any physician – patient relationship. We suggest that visitors to this site discuss information contained here with their own physician.