The Gastric Sleeve and the Gastric Bypass are two of the most common bariatric procedures that doctors recommend when addressing obesity. About 60% of bariatric procedures performed worldwide in 2021-2022 was the Gastric Sleeve, about 30% was the Roux-en-Y gastric bypass, and about 10% for all others (F. A. Kamal, 2024). Here are the key differences between the two procedures:
1. Procedure Type:
Gastric Bypass: Also referred to as Roux-en-Y gastric bypass, this surgery involves creating a tiny pouch and directly connecting it to the small intestine. This effectively bypasses a significant portion of the stomach and a segment of the small intestine. As a result, the amount of food one can consume is restricted and the absorption of nutrients and calories is also decreased.
Sleeve Gastrectomy: Also referred to as gastric sleeve surgery or laparoscopic sleeve gastrectomy, this surgery involves removing about 70-80% of the stomach, resulting in a smaller stomach in the shape of a sleeve. The stomach size is reduced, however, the digestive tract’s pathway remains the same, which means digestion and absorption occur more or less as usual.
2. Mechanism of Weight Loss:
Gastric Bypass: Achieves weight loss through both restriction (smaller stomach pouch) and malabsorption (less food is absorbed due to bypassed intestine).
Sleeve Gastrectomy: Primarily achieves weight loss through restriction, as the remaining stomach limits the amount of food that can be consumed at one time.
3. Impact on Gut Hormones:
Gastric Bypass: Changes in gut hormones that promote satiety (feeling of fullness) and suppress hunger can be more significant, due to the rerouting of the intestines.
Sleeve Gastrectomy: Also affects gut hormones, but the c
4. Complexity and Risk:
Gastric Bypass: Generally considered more complex and carries higher risk due to the rerouting of the intestines. This includes risks like nutrient deficiencies and dumping syndrome (rapid gastric emptying causing nausea, weakness, sweating, faintness, and possibly diarrhea after eating).
Sleeve Gastrectomy: Considered less complex with a slightly lower risk profile. Since the intestines are not altered, there are fewer risks related to malabsorption. However, complications like leakage along the staple line of the stomach can occur.
5. Reversibility:
Gastric Bypass: Technically reversible but involves complex surgery that most surgeons avoid unless medically necessary.
Sleeve Gastrectomy: Is not reversible since the procedure involves permanently removing a significant portion of the stomach.
Both surgeries require lifelong changes in eating habits, nutritional supplementation, and medical follow-up to monitor for complications and nutrient deficiencies. The choice between the two depends on various factors, including the patient’s health, weight loss goals, and potential risk tolerance. It is best to schedule a private consultation with bariatric experts like the team at West Medical, to determine which procedure is the best fit for your lifestyle. Receiving the right support every step of the way is the key to a successful weight loss journey, start yours today!