Sleeve Gastrectomy or Gastric Bypass Surgery?

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. 

There are different elements that are taking in to account to choose a procedure:- Weight and height (BMI)- Body composition ( body fat percentage)- Medical conditions associated ( Diabetes, high blood pressure, obstructive sleep apnea, etc.)- Patient lifestyleIf you are interested in this possibility, you need to arrange a consultation with a certified bariatric surgeon. He will be able to advise you which could be the right treatment option for your specific situation. But the gastric sleeve is a less invasive procedure than bypass, also very safe and has become the most popular procedure performed world wide. New scientific data has shown comparable results with bypass, to be as effective in weight loss and in remission or control of chronic illness. With a gastric sleeve you can carrie on with a more normal life style with out drastic changes.

Choosing between sleeve gastrectomy and gastric bypass depends on your individual health needs, weight loss goals, and lifestyle. Both are effective weight loss surgeries, but they work in slightly different ways and have unique benefits.
Sleeve gastrectomy involves removing about 80% of the stomach, leaving a smaller, sleeve-shaped stomach. This limits how much food you can eat and reduces hunger by lowering levels of the hunger hormone ghrelin. It’s less invasive than gastric bypass and doesn’t alter the digestive process, which means fewer risks of nutritional deficiencies. The procedure is highly effective for weight loss, with most patients losing about 50–70% of their excess weight within the first 12 to 18 months. It’s also a great option for people with fewer obesity-related health issues or who want a simpler procedure with a shorter recovery time.
Gastric bypass, on the other hand, is more complex. It involves creating a small stomach pouch and rerouting part of the digestive system, which limits food intake and reduces calorie absorption. This procedure is often recommended for people with severe obesity or obesity-related health conditions such as type 2 diabetes, as it tends to result in faster and more dramatic weight loss—about 60–80% of excess weight. Gastric bypass may also have additional benefits for managing certain conditions like acid reflux, which can worsen with sleeve gastrectomy.
To decide, it’s essential to work with a bariatric surgeon. They’ll evaluate your health, medical history, and personal preferences to recommend the best option for you. Both procedures can deliver excellent results, so the choice ultimately comes down to your individual circumstances.

Hello,
Thank you for your question.
If your main intention is just to lose weight, I would recommend sleeve gastrectomy; however, if you have metabolism-related side-diseases such as diabetes, hyper-tension or hypercholesterolemia; you may choose a gastric bypass.
I hope this answer helps you
Dr HE

Gastric Sleeve has become a very popular surgery, because weight loss is similar to the bypass, but with quicker recovery, fewer complications, and from what we've seen, better long term weight loss.  

Hi there! Great question... personally I recommend the sleeve gastrectomy as the go to procedure for weight loss nowadays.  There are numerous publications with great data demonstrating the gastric sleeve is safer, achieves the same weight loss (if not more), better quality of life after surgery, and overall better procedure than a gastric bypass.  For example, gastric bypass re-organizes your intestines and the normal anatomy which alters digestion and can lead to future problems such as internal hernias which require emergent surgery.  With the gastric sleeve, it is purely a restrictive procedure which removes approximately 80% of your stomach and this allows you to eat less which in turn allows you to lose excess weight.  Additionally, the hormone Ghrelin which is responsible for controlling appetite is reduced which further helps patients lose weight.  If you have anymore questions don't hesitate to contact me personally to discuss your options!

If you could choose between the two procedures, then a sleeve gastrectomy would be my choice. This is without taking into account other factors that have not been mentioned. A sleeve has less potential for complications (short and long term) and generally quicker recovery.But there are other factors you need to take into account before making the decision. I suggest you discuss your situation with a qualified bariatric/metabolic surgeon who can go through the risks and benefits of each.

We prefer the sleeve. It is easier on the patient and myself as the surgeon. We see great results and is much less invasive than the bypass. Even my heaviest patients, I recommend the sleeve and have had great results. You have much less potential for complications with the sleeve.

The choice between the sleeve gastrectomy and gastric bypass depends on the degree of one's obesity as well as the severity co-morbid conditions as well as the surgery associated risk factors. That choice at times can be very easy, but at times very difficult and should be done on a case-by-case basis by a knowledgable and experienced bariatric surgeon.

The simple answer is that they are both effective if and only if you change your lifestyle...
Start with minimum of 30 minutes walk daily and staying on a low calorie, low carb diet with high protein intake!
Regardless, I believe that Sleeve is less invasive with lower chance of vitamin deficiency, particularly Anemia due to low Iron and B12 level!
Also less change of bowl obstruction and Marginal Ulceration with sleeve as anatomy is not changed.
At the end only you with consultation with your surgeon can decide which option is better for you. Gastric Sleeve or Gastric Bypass!!!