They’re two of the most popular bariatric surgeries available today, so is gastric sleeve or gastric bypass the best choice for you? When evaluating the pros and cons, it’s important to look at three key areas: the procedure itself, what recovery is like, and how the surgery affects your day-to-day life afterward.
Gastric bypass surgery sections off a small stomach pouch and then attaches it to a part of the small intestine. The method uses both restriction and malabsorption—meaning it limits the amount of food you can eat and the amount of nutrients you can absorb—to promote weight loss. It takes between two and four hours, depending on the technique, and is considered a relatively complex surgical procedure.
Gastric sleeve is a minimally invasive laparoscopic procedure where 60 to 80 percent of the stomach is removed, along with most of the “hunger hormone,” ghrelin. The remaining stomach is formed into a tube-shaped “sleeve,” which limits the amount of food you can eat. There’s no rerouting of the intestine, and the surgery time is about 25 to 35 minutes with our technique. The reduced OR time and anesthesia translates into a safer, less complex procedure.
Many gastric bypasses today are done laparoscopically, which helps keep the recovery time shorter than in the past. Nausea is a very common side effect of the surgery, however, and patients will stay on a clear liquid diet for at least two weeks post-surgery. Patients remain in the hospital for two to three days and begin walking short distances before discharge.
The post-operative experience is fairly similar to gastric bypass. Typically, an upper gastrointestinal study is performed 24 hours after the surgery to identify a rare leak, and discharge is usually two days after the procedure. Patients begin walking to the restroom within two to three hours of waking up, can drive in three or four days, and may return to work in as little as five days. Gastric sleeve side effects are minimal in general, and my stats are even lower. Zero percent of my patients (and keep in mind I’ve had more than 11,500) have experienced complications like pulmonary embolism, post-op bleeding, or small bowel obstruction.
The most common complaint of gastric bypass patients is an extremely uncomfortable feeling called “dumping syndrome.” This condition, which happens mainly when eating rich, carb-heavy, or sweet foods, includes rapid heartbeat, palpitations, sweating, and dizziness. The problem? Food passes into the small intestine largely undigested, thanks to the changes in the stomach and intestines. Around 30 percent of patients develop nutritional deficiencies like osteoporosis and anemia for the same reason. Most bypass patients lose between 60 to 80 percent of excess weight in the first year.
Because anatomical changes are relatively minor, the vast majority of gastric sleeve patients don’t develop nutritional deficiencies or dumping syndrome. Intact intestines also mean that gastric sleeve doesn’t require regular blood work to check for deficiencies. Patients lose 50 to 70 percent of excess pounds within the first two years, thanks to both a smaller stomach (which holds three to four ounces) and the substantial decrease in ghrelin production. Most patients love the new feeling of becoming full quickly. Another bonus: Without dumping syndrome to make you feel sick after eating certain things, no food is off limits.
Many elements of gastric bypass and gastric sleeve are similar, including a relatively quick recovery and substantial weight loss results. But there are also meaningful differences in both the procedures themselves and how you’ll live afterward. As always, the Endobariatric team is happy to talk to you about the pros and cons of gastric sleeve!
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