Both gastric sleeve and gastric bypass are weight loss procedures that reduce the size of the stomach. The new smaller ‘sleeve’ or ‘pouch’ holds less food than the regular stomach, which causes patients to feel full with less food. In addition, ghrelin, also known as the hunger hormone, is reduced with both surgeries, allowing patients to wait longer in between meals before feeling the need to eat again. So what exactly is the difference between these two bariatric procedures then? The major difference is in how the stomach is reduced.
Gastric bypass is a malabsorptive procedure that “bypasses” a large portion of the stomach as well as part of the small intestine, creating a small stomach pouch that is then reconnected to the small intestine. As this is a more complex procedure in comparison to gastric sleeve, there is a higher risk of complications and a higher risk of nutritional deficiencies. To qualify for this bariatric procedure, patients need to have a BMI of 40+ and on average lose 60-80% of their excess weight.
Gastric sleeve on the other hand is a restrictive procedure. In gastric sleeve surgery, surgeons enter the stomach laparoscopically to surgically divide and remove about 75-80% of the original stomach, leaving behind a sleeve-like portion very similar to a banana. The connections to the esophagus and small intestine are left intact. Both gastric bypass and gastric sleeve are considered minimally invasive, but sleeve gastrectomy carries less risk of complications, a shorter clinic stay, and faster recovery. To qualify for this type of weight loss surgery, patients need a BMI of 30+ and on average are expected to lose 60-70% of their excess weight.
There are many advantages to choosing gastric sleeve over other bariatric procedures. Sleeve gastrectomy is a quicker operation, meaning you spend less time under anesthesia. There are also fewer risks of complications such as leaks, internal hernias, as well as bowel obstruction. Additionally, gastric sleeve does not affect anything critical as to how the stomach works naturally. This means there are minimal effects on the digestive process which reduces the risk of dumping syndrome and/or malabsorption complications as seen with gastric bypass.
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