Is Gastric Sleeve or Gastric Bypass Better?

Each year in the United States, approximately 113,000 bariatric (weight loss) surgeries are performed. Two of the most common types of bariatric surgeries include the gastric sleeve and the gastric bypass. These surgeries have some commonalities along with some important differences that will help you decide which procedure is right for you. If you’re considering weight loss surgery, this article has information that you need to know.

What is Gastric Sleeve Surgery?

The gastric sleeve procedure, also called the sleeve gastrectomy, is a surgical procedure to permanently remove 80% of your stomach. The rest of the stomach is stapled into a sleeve which allows digested food to pass through as before. Dr. Patel performs the procedure via robotic minimally invasive surgery with 4 small incisions. 

Gastric sleeve surgery restricts your ability to overeat by reducing the amount of food the stomach can hold. You’ll feel full sooner and stop eating. This reduces caloric intake so you can lose weight. 

Gastric sleeve surgery also works by making you less hungry. The part of the stomach that produces ghrelin, which is a hormone that causes you to feel hungry, is removed. Patients lose weight slowly; in the first year to 18 months, you may lose 60 to 70% of the excess weight as long as you are committed to the lifestyle changes that go along with the surgery.

The surgery takes about an hour and half to perform. You might be in the hospital for one to two days. After surgery, you will be on a liquid diet for 2-4 weeks and then gradually can begin to introduce soft solid foods slowly into your eating routine.

Patients that select this surgical procedure often have tried diets and exercise on and off for years but still struggle with their weight.

What is Gastric Bypass Surgery?

Gastric bypass, also known as Roux-en-Y gastric bypass, is also a type of weight loss surgery. However, it’s a bit more complex than gastric sleeve surgery.

During the surgery for gastric bypass: 

  • A small pouch the size of a medicine cup is created from your stomach
  • The intestine is now rerouted or bypassed to the newly created gastric pouch

 Like the gastric sleeve procedure, Dr. Patel performs the gastric bypass with robotic minimally invasive surgery via 5 small incisions.

Gastric bypass is typically performed when exercise and diet changes haven’t worked to help the person lose weight. Obesity can create serious health complications, but a gastric bypass can cause dramatic weight loss and potentially improve the health of the bariatric surgery patient.

Gastric bypass, as well as gastric sleeve, can help lessen the risk of serious health problems such as:

  • Cancer
  • Gastroesophageal reflux disease
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Infertility
  • Obstructive sleep apnea
  • Type 2 diabetes
  • Stroke

Gastric Sleeve Versus Bypass—Which is Better?

The goal of both gastric sleeve and bypass surgery is the same: to reduce your stomach from its normal size to a small pouch. This prevents people struggling with obesity from overeating. Both surgeries help thousands of people lose weight, and neither surgery is better than the other. The recovery time in the hospital from both procedures is one to two days. However, there are pros and cons to both procedures that you should weigh with your doctor.

Gastric sleeve pros:

  • You can lose up to 65% of excess weight
  • It’s a one-step procedure with low risk of complications
  • Recovery is fast
  • You’ll have fewer issues absorbing vitamins and nutrients

Gastric sleeve cons:

  • Weight loss is slightly less than with gastric bypass
  • It can cause acid reflux
  • It’s irreversible

Gastric bypass pros:

  • You can lose up to 80% of your excess weight
  • It works in two ways; to lessen the amount you can consume but also to reduce the calories absorbed
  • Weight loss is faster than with the sleeve procedure
  • Resolves reflux
  • Can be reversed if needed

Gastric bypass cons:

  • Small risk of internal hernia
  • There is a risk of malabsorption of vitamins and nutrients
  • A condition called dumping syndrome is more likely to occur

One big difference between these procedures is the size of the stomach pouch the surgeon creates:

  • Gastric sleeve surgery creates a stomach pouch that can hold about three ounces of food
  • Gastric bypass surgery creates a pouch that can only hold an ounce of food at a time

Both of these bariatric surgeries are commonly done laparoscopically. As a result, the recovery time for both is similar. Gastric bypass is more complicated but both surgeries are relatively safe procedures. The risk of major complications for both types of surgeries is about 1-2%.

The dietary changes you make after these bariatric surgeries are, for the most part, the same. You will consume only liquids for a time then transition to soft foods. Two months or so after these surgeries you can begin to introduce regular food again.

Chetan J. Patel, M.D.

About Dr. Patel

Native to Central Florida, Chetan J. Patel, M.D., FACS, is a board-certified general surgeon and fellowship-trained in advanced gastrointestinal, minimally invasive, and bariatric surgery. He is humbled to offer cutting-edge, personalized care to patients in Lake Nona, Orlando, Oviedo/Winter Springs, Lake Mary, Winter Park and Orlando.

Why Would I Need a Gastric Sleeve or Gastric Bypass Surgery?

Bariatric surgery is typically used when diet and exercise fail to bring about weight loss and the person’s health is threatened by a host of complicating diseases like high cholesterol, heart disease, fatty liver, or other disorders.

Orlando Minimally Invasive Surgery uses minimally invasive techniques whenever possible. Minimally invasive bariatric surgery uses smaller incisions, which gives patients less pain, faster healing, and better health outcomes. These procedures often get you out of the hospital more quickly than traditional open surgery. 

If you’ve been struggling with weight loss, talk with our team about your options.

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Hospital privileges at Oviedo Medical Center,  AdventHealth, and Orlando Health.

Serving Lake Nona, Lake Mary, Orlando, Winter Park, and
Oviedo/Winter Springs.