Comparing Different Types of Bariatric Surgery

Gastric-Sleeve-BypassIf you suffer from obesity, you are not alone. Approximately 78.6 million people in the United States suffer from this disease. At Texas Laparoscopic Consultants, our compassionate bariatric surgeons perform weight loss surgery for patients in the Houston area and from around the world. Bariatric surgery is an excellent tool for individuals who are dedicated to losing the excess weight — and keeping it off over the long run.

Typically, we do all our procedures laparoscopically, which means less scarring and a quicker recovery for you.

Here is a look at the most popular types of bariatric surgery and how they compare to each other.

Gastric Sleeve vs. Gastric Banding

Gastric Sleeve

Gastric sleeve surgery, also called sleeve gastrectomy, is a weight loss surgery that involves removing about 70 percent of the stomach. This limits, or restricts, the amount of food an individual can consume following the procedure. The remaining section of the stomach resembles a long cylinder, or a sleeve. Because the natural flow of food remains intact, digestion continues as normal, but patients feel full after eating smaller amounts of food.

In addition to restricting the amount of food a patient can eat after surgery, removing much of the stomach during sleeve gastrectomy also leads to a substantial decrease in the amount of Ghrelin that the stomach produces. Ghrelin is a hormone that stimulates a person’s appetite. With less Ghrelin, individuals do not feel as hungry. This also helps patients’ weight loss efforts.

With gastric sleeve surgery, patients can expect to lose about 65-70 percent of their excess body weight in the first year. At that point, the weight loss rate slows until it eventually stops. Exercise and a healthy diet will ultimately help determine the final weight loss.

Gastric sleeve surgery is an advanced treatment option that is often suitable for individuals who are not appropriate candidates for other types of bariatric surgery, such as gastric bypass, due to extremely high body mass indexes (BMI) or other increased risk factors, such as Barrett’s esophagitis.

Gastric Banding

Adjustable gastric banding surgery is another type of restrictive weight loss surgery. With gastric banding surgery, the surgeon places a hollow, plastic, belt-like band around the upper section of the stomach, which creates a smaller stomach pouch. This limits the amount of food a patient can eat after surgery and allows them to feel full faster, when the balloon inside the band is tightened.

The original banding device used in this procedure is called the Lap Band. For this reason, the procedure is often referred to as “Lap-Band surgery.” Today, another banding device, called the REALIZE Band, is available as well. This device is also FDA approved for use in the United States in gastric banding bariatric surgery.

Unlike gastric sleeve surgery, gastric banding surgery is reversible and adjustable. This means that the gastric band can be removed if the patient suffers complications from the device or chooses to pursue another type of bariatric surgery because of the lack of weight loss.

With gastric banding surgery, the surgeon places an empty band around the stomach. Once the patient has healed from the procedure, the surgeon uses an access port located under the skin to fill the band with saline solution (sterile saltwater), thus tightening it and restricting the amount of food the individual can eat at one time.

Gastric banding patients should aim to lose about 1 pound per week, during the first 12 to 18 months following surgery. The typical weight loss is 50 percent excess body weight. However, this procedure requires the most follow-up by the patient.

Gastric banding surgery is often appropriate for patients with a BMI of at least 35. It may also be performed for individuals with a BMI of 30-35 if at least one obesity-related co-morbid health condition is present (e.g., type-2 diabetes, high blood pressure, high cholesterol, asthma, obstructive sleep apnea).

A Note About Laparoscopic Surgery

Both gastric sleeve and gastric banding surgery can be performed laparoscopically, when medically appropriate for the patient. With laparoscopic surgery, the surgeon makes several small incisions in the treatment area instead of one large incision, as happens with traditional “open” surgery. The surgeon inserts his instruments into the treatment area through these small incisions. A laparoscopic camera is then used to proceed with the surgery. Thanks to the several small incisions used, laparoscopic surgery is much less invasive than the traditional open approach.

Gastric Sleeve vs. Gastric Bypass

Roux-en-Y gastric bypass surgery is still the gold standard for bariatric surgery in the U.S. It is an appropriate treatment option for patients suffering from morbid obesity (generally a BMI of 40 or higher).

Similar to gastric sleeve, gastric bypass is performed laparoscopically. With gastric bypass, the surgeon reshapes the upper stomach to about the size of an egg. Unlike with gastric sleeve surgery, no portion of the stomach is removed. The bariatric surgeon then creates a small connection between the new stomach and the intestine. (The upper section of the small intestine that is reattached forms a “Y” shape; this is why the gastric bypass technique is called the Roux-en-Y approach.) This allows any food consumed by the patient to bypass the main portion of the stomach.

Gastric-Sleeve-BandGastric bypass works in three ways to help patients lose excess weight. First, it is a restrictive procedure in that a smaller stomach pouch is created, thereby limiting the amount of food a patient can eat. Second, unlike gastric sleeve surgery, Roux-en-Y gastric bypass surgery has a slight malabsorptive component. Third, the procedure has a metabolic component that works to increase levels of gut hormones — including peptide YY (PYY) — which helps individuals feel satisfied after a small meal. It also improves GLP-1, which leads to rapid improvement of blood sugars in diabetics.

Weight loss with the gastric bypass is similar to gastric sleeve. Patients can expect to lose about 65-70 percent of their excess weight in 9-12 months.

Learn More About Your Bariatric Surgery Treatment Options

To schedule a consultation with one of our compassionate, experienced bariatric surgeons, please contact Texas Laparoscopic Consultants by calling (713) 493-7700.