Sleeve Versus Other Bariatric Options

If 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 a range of advanced weight loss surgery options for patients in the Houston area and those traveling from afar. Bariatric surgery is an excellent tool for individuals dedicated to losing excess weight — and keeping it off over the long run. Typically, our weight loss procedures are performed laparoscopically, which means less scarring and a faster and more comfortable recovery for you. Below you’ll find information on the two most popular types of bariatric surgery and how they compare.

What Is Laparoscopic Surgery?

With laparoscopic surgery, the surgeon makes several small incisions on the abdominal wall instead of one large incision, as with traditional “open” surgery. The surgeon inserts his instruments through trocars placed through these small incisions. Carbon dioxide is used to insufflate the abdominal cavity to allow room for the surgeon to work. A camera is placed through one of the trocars to allow for visualization. The small incisions make laparoscopic surgery much less invasive than the traditional open approach.

Gastric Sleeve

Gastric sleeve surgery, also called sleeve gastrectomy, is a weight loss surgery that involves removing about 70% of the stomach to limit, or restrict, 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 and therefore consuming fewer calories.

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 known as the “hunger hormone” because it is the hormone responsible for stimulating appetite. With less Ghrelin, individuals do not feel as hungry. This also helps patients’ weight loss efforts.

Following gastric sleeve surgery, patients can expect to lose about 65-70% of their excess body weight in the first year. At that point, the rate of weight loss 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 an excessively high body mass index (BMI) or other increased risk factors, such as Barrett’s esophagitis.

What is a Gastric Sleeve?

Dr. Sherman Yu explains the laparoscopic sleeve gastrectomy surgery.

How Is Gastric Sleeve Performed?

Watch this detailed animation of how the gastric sleeve (or sleeve gastrectomy) procedure is performed.

Sleeve Gastrectomy Surgery at TLC

In this video from Texas Laparoscopic Consultants, learn how the sleeve gastrectomy procedure works to achieve weight loss.

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.”

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 insufficient 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 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% 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 comorbid health condition is present (e.g., Type-2 diabetes, high blood pressure, high cholesterol, asthma, or obstructive sleep apnea).

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 a gastric sleeve, gastric bypass is performed laparoscopically. With gastric bypass, the surgeon reshapes the upper stomach to roughly the size of an egg. Unlike 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 reattached small intestine 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 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, 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 increases 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% of their excess weight in 9-12 months.

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

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The TLC Surgery Doctors have either authored or reviewed and approved this content.

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