What Is the Difference Between Gastric Sleeve and Gastric Bypass?

Weight loss surgery, in general, is meant to help people address obesity that has been unresponsive to a reduced calorie diet and regular exercise. When exercise and good nutrition fail to produce meaningful weight loss, surgery may be a viable option. Two of the most widely used bariatric surgeries are the gastric sleeve and gastric bypass. What is the difference between these two procedures, and when might one be indicated over another?

Gastric Bypass Surgery

Also known as Roux-en-Y anastomosis or Roux-en-Y gastric bypass (RYGB), this surgery is perhaps the most well-known of weight loss procedures. Dr. Malladi’s gastric bypass procedure is laparoscopic, which is less invasive and speeds healing. During the operation, stomach size is reduced, and the intestines rerouted to bypass the duodenum.  This limits the amount of food the stomach can hold and reduces the number of calories the body can absorb.

The team at Malladi Bariatric and Advanced Surgery may recommend gastric bypass if you have been unable to achieve weight loss after medically supervised weight loss has not been successful. Criteria for gastric bypass surgery is a BMI over 40 or BMI over 35 with co-morbidities such as diabetes, heart disease, and high blood pressure.

Gastric Sleeve Surgery

A gastric sleeve surgery removes part of the stomach, such that a small “sleeve” of it is left behind. The sleeve of the stomach holds less food and helps the individual manage portion sizes more effectively. Like the gastric bypass, Dr. Malladi uses laparoscopy to reduce the incision size and facilitate quicker healing after surgery.

The gastric sleeve surgery is very similar to gastric bypass in that it can help jumpstart the weight loss process. Like RYGB, it is not a replacement for good nutrition and regular physical activity. Gastric sleeve surgery may be indicated if you have a BMI over 40 or you have a BMI of over 35 and experience severe symptoms as a result of excessive weight. Surgery may also be an option if you have serious medical conditions exacerbated by your obesity, such as diabetes or high blood pressure.

All surgeries have both risks and benefits. The team at Malladi Bariatric and Advanced Surgery may recommend gastric bypass or gastric sleeve surgery if they believe the benefits of the procedures outweigh the risks of having. Though gastric sleeve and bypass are laparoscopic at Malladi Bariatric and Advanced Surgery, certain side effects can occur. These include:

  • Bowel obstruction
  • Pain at the surgical site
  • Gastrointestinal symptoms such as nausea, vomiting, or diarrhea
  • “Dumping syndrome,” or rapid gastric emptying
  • Post-operative infection
  • Inability to eat certain foods.

No matter what procedure you receive, it is important to follow all instructions and lifestyle changes issued by your providers. The risk of complications, such as bowel obstruction or perforated stomach, are higher if you do not follow the dietary guidelines recommended by Dr. Malladi’s team.

Choosing Between Gastric Sleeve and Gastric Bypass

When you are deciding between these two procedures, know that the choice between them depends on your unique situation. Gastric bypass is the better option for patients who are very obese – those with a BMI of 45 or over as it tends to produce a somewhat faster rate of weight loss. Gastric sleeve can be easier to tolerate for patients who have a digestive condition (e.g. IBS, celiac disease) because it comes with a lower occurrence of dumping syndrome. This syndrome occurs for some patients who undergo gastric bypass but less often for those who undergo a gastric sleeve procedure. For patients who already have stomach issues, a sleeve might offer a better recovery.

Of course, your surgeon is the best resource for help in making such decisions.  An experienced weight loss surgeon will review your medical history and recommend the best bariatric procedure for you based on your medical condition and your weight loss goals.  If you are struggling to lose weight despite making positive lifestyle changes, you may be a candidate for weight loss surgery. Dr. Malladi’s team can help – contact us for a consultation and learn more about your options.