Thinking about weight loss surgery and trying to determine the differences between the surgical options for weight loss?
Both the laparoscopic sleeve gastrectomy and the laparoscopic roux en y gastric bypass are great options for losing weight and improving your health; however, it is important to recognize the differences between the two options.
In this blog, we explain how each surgery works, what to expect during recovery, and which option might be right for you.
How The Gastric Sleeve Works
Let’s begin with the gastric sleeve, or sleeve gastrectomy. In this surgery, we staple off about 80% of the stomach, leaving the stomach in the shape of a small banana.
This works in two ways. A smaller stomach means less room for food, meaning you will feel full, faster, off of small portions. This is known as restriction. The more important mechanism, however, is the metabolic benefit of removing the fundus of the stomach, which is the portion involved in many neurohormonal mechanisms that are involved in regulating the metabolism.
Why Choose a Gastric Sleeve?
A gastric sleeve might be right for you if you are desiring to lose a significant amount of weight (about 30% of your current body weight), obtain better portion control, and improve metabolic comorbidities. A roux en y gastric bypass is better for moderate level diabetics, and those with severe heartburn. Ask your surgeon which may be a better option for you.
What Are the Risks?
The gastric sleeve carries a risk to develop heartburn (or gastroesophageal reflux disease) over time.
How Does Gastric Bypass Work?
The surgeon divides the stomach to create a small pouch which is about the size of an egg. . We divide this pouch from the fundus of the stomach, which leads to the metabolic effect of surgery that we see with the gastric sleeve. We then bring up a loop of intestine to connect to the pouch, so that a significant portion of the intestines are “bypassed”, leading to malabsorption, or decreased absorption of calories, which leads to more weight loss.
Why Choose Gastric Bypass?
The gastric bypass surgery process has the following significant advantages:
- You can expect to lose about 35 – 40% of your body weight with the roux en y gastric bypass.
- While both the gastric sleeve and bypass can improve outcomes for people with diabetes, the bypass has longer term remission rates of diabetes over the sleeve gastrectomy.
- Bypass may be a better option for those with severe heartburn or reflux symptoms.
What Are the Risks?
Because of the malabsorptive component, weight loss may be higher with bypass but there is a higher chance of nutritional deficiencies since the body absorbs fewer vitamins and minerals
Dumping syndrome is a side effect of the connection between the stomach and the intestine, and occurs when a high carbohydrate load passes from the stomach into the intestine. You might get dumping syndrome, which is not such a fun experience of stomach rumble, nausea, cramps, and sometimes diarrhea after consuming glucose or any high-fat meal. This is not a risk after gastric sleeve.
The connection between the stomach and intestine is sensitive to ulceration, and patients must avoid all NSAIDs like aspirin, motrin, and aleve after bypass surgery.
There is also a smaller lifetime risk for a type of bowel obstruction called an internal hernia. Ask your surgeon for more details regarding these risks.
Which One Is Right for You?
The proper procedure depends on your health needs and weight loss goals. Gastric sleeve surgery is less complex, and we recommend it for individuals seeking a less invasive procedure with a lower risk of complications. Gastric bypass surgery may be more suitable for individuals with moderate-level type II diabetes or severe reflux disease. This procedure often results in more substantial and fast weight loss and has a higher diabetes remission rate than gastric sleeve. When deciding between the two options, consulting with a qualified bariatric surgeon is crucial. They will take the time to understand your unique medical conditions and weight loss goals so that they can guide you toward the option that’s the best fit for you.
Final Thoughts
If you are considering weight loss surgery, consult with a bariatric specialist, such as our professionals at Torrance Bariatrics, to determine the best option for your health and lifestyle.
