Sleeve Gastrectomy or Gastric Bypass Surgery?

I need to choose between sleeve gastrectomy and gastric bypass surgery, what do the medical experts think is most effective between the two? I don't know how to make this decision? Please help!

Doctor Answers 7

Sleeve gastrectomy is the most commonly performed procedure in the world

Sleeve is less invasive than gastric bypass. The normal anatomy is not re-configured with sleeve gastrectomy hence saving from longterm complications like internal hernias, marginal ulcers and potential vitamin and mineral malabsorption. As to the effectiveness of sleeve surgery, studies have clearly shown that it is almost as effective as a bypass. Regarding the mechanism of action, sleeve and bypass are both metabolic procedures. This means that hunger and satiety hormones are altered after surgery in such a way that you feel full after consuming a small meal. Other hormones that affect your energy metabolism also change further contributing to weight loss.
Please remember that lifestyle changes are a must to succeed after surgery irrespective of wether you choose sleeve or bypass.

Houston Bariatric Surgeon
5.0 out of 5 stars 3 reviews

Choosing Between Sleeve Gastrectomy and Gastric Bypass

The gastric bypass is still considered the gold standard for bariatric surgery worldwide. There is greater weight loss, better control of co-morbidities, and lesser weight regain in most series of gastric bypass compared to the sleeve. Long term results of sleeve gastrectomy (Doctor Weiner in Germany has one of the largest data) show significant weight regain in sleeve patients after five years. Therefore, if one can find a really skilled surgeon who does a lot of bypasses, with low morbidity, the bypass would be the preferred procedure. Sleeves are a reasonable choice in patients who have significant anemia, are smokers, or have had previous intestinal surgery. Your surgeon, if he is skilled in both procedures, should be able to help you make the right decision. 

Arif Ahmad, MD
Long Island Bariatric Surgeon

Sleeve vs bypass

Both procedures are excellent for weight loss.  Sleeve gastrectomy is restrictive procedure- it works by making your stomach smaller so you will not be hungry with a small meal.  Gastric bypass adds a reconfiguration of your intestinal tract producing malabsorption.  Weight loss out to eight years is the same for both procedures.  Most bariatric surgeons feel that bypass is better for diabetic patients.  For patients without diabetes, both are good choices.  Sleeve is less risky and has more rapid recovery- most vitamin absorption is normal.  Bypass involves more work, has longer recovery and you must be committed to vitamin supplementation for the rest of your life. 

Shawn Garber, MD, FACS, FASMBS
Long Island Bariatric Surgeon
5.0 out of 5 stars 3 reviews

Sleeve or gastric bypass

Both operations are great effective operations performed in the hands of an experienced surgeon.  In making a determination on what is a suitable operation for an individual multiple factors need to be considered.  Nutritional factors such as underlying vitamin deficiencies, your eating habits and hunger level;  your emotional eating behavior, your food addiction susceptibility.  These factors along with additional personal factors such as your aversion to risk and your overall health state to with stand risk of surgery are important in making a decision on which surgery is right for you.  Secondary factor that are related to your physiology and comorbidities, such as diabetes also needs to be considered.  Overall, Gastric bypass is more effective for patients with diabetes.  Additional factors that needs to be considered is your previous operative and history and your anatomy.  If you have a hernia, depending on the size of your hernia your doctor will make a determination on whether a gastric bypass or a laparoscopic sleeve gastrectomy is a more suitable operation. 

Yes gastric sleeve surgery is often an easier and safer procedure to perform and the overall risk is lower than the gastric bypass.  However, the gastric bypass has better published and follow up data for its effective weight loss.  In addition, there are better revision options for the sleeve gastrectomy if the patient is unsuccessful.  Having said that I have patients in both category that do as well and are equally successful, which bring home the underlying theme that surgery is just a tool and how you use it is the most important predictor of your outcome. 

The typical information session for a bariatric patient can take from 1-2 hours of lecture and questioning by the audience to provide initial information on how to think about bariatric surgery.  We then answer general questions from the audience and allow the audience to reflect on their concerns.  Once you have made a determination that surgery is right for you - we will schedule you for a consultation with the physician and the nutritionist.  During the consultation we make sure we have conveyed the information to you and you have understood the information.  Once you have a clear understanding of the procedure you can make an educated decision on what is appropriate.  You are changing your body make sure you understand the issues involved, find a doctor that can take time to explain and listen to you. 

Babak Moeinolmolki, MD, FACS
Los Angeles Bariatric Surgeon
5.0 out of 5 stars 12 reviews

Sleeve Gastrectomy is preferable to Gastric bypass

Yes, it's true that studies show slightly better early weight loss with Gastric bypass than with sleeve gastrectomy; but that comes at a price of more than twice the rate of short-term complications (including death).  Add in the long-term risk of internal hernia, anemia, and osteoporosis, which essentially NEVER occur with sleeve gastrectomy... and to me, there's no question that sleeve gastrectomy is a better option for most patients.

There are also other problems that are being discovered with gastric bypass, such as insulin hypersecretion, which may contribute to long-term weigh regain.

And finally, since both patients carry a risk of weight regain, it is important to note that sleeve gastrectomy has the most salvage options, from re-sleeve, to plication, to conversion to duodenal switch.  There are no good options for patients who regain after gastric bypass.

Mark Pleatman, MD
Bloomfield Hills Bariatric Surgeon
5.0 out of 5 stars 20 reviews

Sleeve Gastrectomy versus gastric bypass surgery

In my opinion, both procedures are effective for weight loss. Gastric Sleeve is less invasive, has less down time and quicker recovery time. You will need one night hospital stay. You will loss significant weight and there is usually no need for supplemental vitamins. With gastric bypass surgery, you could potentially loss more weight. It is more invasive, has longer down time  and may require lifetime of supplements. The best procedure is the one that is selected based on your BMI, your underlying medical condition(s) and the procedure that your surgeon and his team are most comfortable with.

Monali Misra, MD, FACS
Beverly Hills Bariatric Surgeon

Gastric Sleeve or Gastric Bypass

Both surgeries are effective and could be the right surgery for you. The best way to pick between them would be to go to a Bariatric surgeon, and make sure it is one who performs both procedures, so the guidance is not biased to one procedure or the other. 

Daniel J. Rosen, MD
New York Bariatric Surgeon
4.5 out of 5 stars 4 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.