Over the years weight loss surgery has become a very common procedure. This is often done using keyhole techniques. Two of the most common types of operations performed keyhole are sleeve gastrectomy (gastric sleeve) and gastric bypass (Roux-en-Y). These two surgeries are quite different in terms of their advantages and disadvantages.
It is now well established that sleeve gastrectomy is currently the most popular weight loss operation in the world.
Both the sleeve gastrectomy and gastric bypass reduce the size of the stomach dramatically and modulates the amount of hunger hormone (Ghrelin) that is produced by your body. It has been shown in numerous studies that not only can sleeve gastrectomy and gastric bypass produce sustained long term weight loss, they can also improve the overall health conditions of individuals such as heart disease and diabetes, and decreases the risk of premature death by at least 30-50%.
Therefore, which is better – sleeve gastrectomy or gastric bypass? You decide.
Sleeve gastrectomy
Advantages of sleeve gastrectomy
- sleeve gastrectomy decreases the size of the stomach but your digestive system continues to function normally, and therefore there is no chance of problems such as dumping.
- this is thought to be the safest form of weight loss surgery. This is because sleeve gastrectomy surgery is a much more straightforward operation than gastric bypass, which leads to far less complications during or after surgery
- low likelihood of causing problems to your digestive system. The sleeve gastrectomy surgery does not change the way your body absorbs nutrient and vitamins so there is very low chance of poor nutrition, diarrhoea or nausea.
- sustained long term weight loss. After sleeve gastrectomy you would expect to lose up to 60 – 70% of excess weight.
- cures medical conditions associated with excess weight. Sleeve gastrectomy improves or cures medical conditions such as Type 2 diabetes, high blood pressure, sleep apnoea, polycystic ovarian disease and infertility.
Disadvantages of sleeve gastrectomy
- the rate of weight loss is slower after sleeve gastrectomy. It might take a little longer to reach target weight but studies have shown no difference in long term weight loss between sleeve gastrectomy and gastric bypass.
- can cause or worsen acid reflux. After sleeve gastrectomy a small percentage of people will develop acid reflux but this can usually be treated medically.
- minimal risk of long term complications. Sleeve gastrectomy has a very low risk of long term problems other than reflux.
Gastric bypass
Advantages of gastric bypass
- relatively rapid weight loss initially. Because you are taking less nutrients, weight loss may be more rapid initially but long term it is similar to sleeve gastrectomy
- excess weight loss. After gastric bypass the expectation is to lose 60-70% of excess weight.
- cures or improves medical conditions. After gastric bypass, you will see a cure or improvement in Type 2 diabetes, high blood pressure, sleep apnoea, polycystic ovarian disease and infertility.
- improvement in acid reflux is likely. If you have severe reflux, gastric bypass is a good option as a weight loss surgery but about 20% of people will still have chronic reflux after this surgery.
Disadvantages of gastric bypass
- likelihood of dumping syndrome. After gastric bypass it is highly likely that you will develop dumping syndrome after eating certain foods. Dumping syndrome is an unpleasant medical condition which leads to diarrhoea, hot flushes, dizziness, nausea and vomiting.
- likelihood of vitamin and mineral deficiencies. After gastric bypass surgery about 60% – 70% of people will become deficient in vitamins and minerals such as Vitamin B12, folic acid, iron and calcium.
- gastric bypass surgery is more complex. Gastric bypass surgery is more complex than sleeve gastrectomy due to the reorganisation of your GI tract and therefore there is a high chance of problems such as leaks or infections.
- possibility of long term complications. Although these problems are not common, after gastric bypass surgery there is a 5-20% long term chance of problems such as issues with nutrition, stomach ulceration and bowel blockages, these problems are not seen after sleeve gastrectomy.
