Gastric sleeve vs gastric bypass
Gastric sleeve and gastric bypass surgeries both result in significant weight loss for patients, but they have key differences.
Australia has one of the highest rates of obesity in the developed world. Obesity is associated with type II diabetes, cardiovascular disease, infertility, cancer and many other disease conditions. Obesity causes excess morbidity and mortality. It is important to control obesity to prevent this sequelae of disease.
Over the recent decades bariatric surgery has been able to help many obese patients lose significant amounts of weight. This has resulted in beneficial health outcomes for many resulting in reduced mortality and better life quality.
Among the most bariatric procedures performed in Australia are the gastric bypass and gastric sleeve surgeries. Although both gastric sleeve and gastric bypass surgeries produce similar weight loss outcomes, there are some key differences between them.
If you are considering either surgery it is important to be informed on these differences. In this article we’ll explain how each of these surgeries work, what outcomes patients may expect, and some of the pros and cons of each procedure.
Gastric sleeve vs bypass surgery
The gastric sleeve and gastric bypass are bariatric surgeries which help patients lose weight. Due to the rise in prevalence of obesity in Australia, these procedures are routinely performed in many hospitals and medical facilities.
Gastric Sleeve (Sleeve Gastrectomy)
Gastric sleeve surgery is one of the most popular bariatric surgeries performed in Australia. It is a relatively new procedure, first performed in 1990 and modernised to a less invasive laparoscopic (keyhole) surgery in 1999.
It is an irreversible restrictive bariatric surgery. This means that it works by reducing the amount of food a person can fit in their stomach. This is achieved by removing a part of the stomach and leaving the patient with a smaller “sleeve” shaped stomach.
The remaining “sleeve” holds a capacity of about 80-90% less capacity, which greatly restricts how much a person can eat at any one time. This prevents overeating and reduces calorie intake, which can ultimately lead to weight loss.
Gastric Bypass (Roux-en-Y gastric bypass)
A gastric bypass is another type of popular bariatric surgery performed in Australia. It is considered a restrictive-malabsorptive procedure and can be performed using a number of techniques but most commonly, it is done through keyhole surgery.
A gastric bypass surgery involves the creation of a new smaller stomach pouch using the patient’s original stomach. The new pouch is then attached to a section of the second part of your small intestine. This attachment means food and nutrients bypass the rest of the stomach and the beginning of the small intestine. However, the bypassed section is attached further along the digestive tract so that pancreatic chemicals can still help digest food and nutrients properly.
Because a large proportion of food nutrients are absorbed at the beginning of the small intestine, which is bypassed in the procedure, the surgery results in less food absorption. It also restricts the food intake due the creation of a smaller stomach pouch. This is why it is both a restrictive-malabsorptive procedure.
Gastric sleeve vs bypass recovery time
When comparing gastric sleeve vs bypass recovery time, it is important to note that everybody’s recovery will vary depending on patient factors and procedural factors. Patient factors include things like age and comorbidities, while procedural factors include things like surgical technique.
Most bariatric procedures performed today are done through keyhole techniques. This means patients benefit from more rapid recoveries, less pain and fewer complications as compared to open techniques.
Generally speaking though, gastric bypass surgeries are more complex than gastric sleeve surgeries. Because gastric bypass surgeries involve multiple steps, patients may require a slightly longer postoperative recovery.
Gastric sleeve vs gastric bypass long-term
No bariatric surgery is a ‘quick-fix’ and the outcomes of gastric sleeve vs gastric bypass long-term, depend on the patient. Many patients will experience significant weight loss and consequently better health outcomes.
- Patients who undergo gastric sleeve surgery can expect to lose around 60% of their excess weight and experience a reduction in obesity associated health conditions.
- Patients who undergo gastric bypass surgery can expect to lose between 60-70% excess body weight, and experience >75% better control of obesity associated health conditions.
However, these long-term outcomes are dependent on how committed patients are to healthier lifestyle changes around their diet and physical activity. Some patients may regain weight, irrespective of the type of bariatric surgery, due to poor control of these lifestyle factors.
Pros and cons of gastric sleeve vs gastric bypass
There is strong evidence for the benefits of bariatric procedures in treating obesity. However as with any other medical interventions, it is important to consider the pros and cons of gastric sleeve vs gastric bypass.
Gastric sleeve surgery
| Pros | Cons |
|---|---|
| Less complex than gastric bypass | May cause or exacerbate reflux |
| Reduced risk of dumping syndrome | Can stretch due to overeating |
| Less postoperative vitamin supplementation than gastric bypass | Requires long-term vitamin supplementation |
| Sleeve can be converted to bypass if necessary | Newer procedure so less long-term data |
Gastric bypass surgery
| Pros | Cons |
|---|---|
| A well-established procedure with strong track record | Can stretch due to overeating |
| Reduces the incidence of obesity related comorbidities | Low risk of dumping syndrome |
| No foreign bodies inserted so less chances of complications | Requires long-term vitamin supplementation. |
| Can serve as revision surgery following gastric sleeve or lap band surgery. | Can result in altered alcohol metabolism |
Gastric sleeve vs gastric bypass, which is better for you?
The choice of gastric sleeve vs gastric bypass depends on multiple factors. Each patient is unique and has different needs, expectations, goals and limits. Having the right surgical expertise is essential for helping guide the decision.
If you are interested in learning more about weight loss surgery or other weight loss options, you can contact the specialist team at Newcastle Obesity Surgery Centre. Request an appointment via our contact form or call us on 02 4058 3936. We are ready to discuss your options and help you optimise your health.
To find out whether you are eligible for either gastric sleeve or gastric bypass surgeries click here to find out or download our Obesity Surgery Information Brochure where you can find information on alternative treatments.
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