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How do you decide between a gastric bypass vs. a gastric sleeve surgery?

There are multiple options to consider once you’ve decided to embark on bariatric or weight loss surgery. Each type of surgery has its own benefits and risks.

Dr. Mullangi will explain the pros and cons of gastric sleeve vs gastric bypass surgeries during your consultation. There are a number of factors to consider in making the decision.

First, we want to share the similarities.

Both gastric bypass (or a Roux-en-Y procedure) and a gastric sleeve are very similar procedures. Both are irreversible, both involve a hospital stay of about 2-3 days, and both operations reduce the amount of food you can eat before feeling full (though in different ways!). Both the gastric bypass and gastric sleeve are done laparoscopically.


Now the differences:

A gastric bypass or a Roux-en-Y procedure involves the attachment of a small pouch to the intestine in order to bypass the stomach. The recovery time is about 2-4 weeks. Patients can expect to lose 60—80% of excess weight within the 1 – 1.5 years!

There is a risk of dumping syndrome (also called rapid gastric emptying), which is when food (especially sugar) moves from your stomach into your small bowel too quickly. We will discuss dumping syndrome in greater detail in a different dedicated post.

A gastric sleeve involves removing a portion of the stomach to produce a sleeve or banana-shaped stomach. The recovery time is similar, also about 2-4 weeks. Patients tend to lose weight more gradually with a sleeve, but they can still lose around 60-70% of excess weight lost by 1.5 years. There is generally a lower risk of dumping syndrome.


How do we advise patients?

As we said, both bypass and sleeve surgeries can be effective tools in achieving long-term weight loss. We generally recommend gastric bypass surgery for very obese patients with a BMI > 45, because it tends to lead to more rapid and higher weight loss overall. That being said, the gastric bypass procedure is a more complicated surgery, so we advise the sleeve for patients who have had multiple abdominal surgeries in the past. Additionally, the anesthesia time is shorter for the sleeve, so we advise this for patients who have severe heart disease or lung problems, transplant candidates or recipients. Lastly, the sleeve is associated with less malabsorption problems, so we advise this for patients who are on important medications such as psychiatric medications, to lower the risk of medication absorption issues.

Each person is different and each person has specific needs that can be met with one or the other surgery. During your consultation, you can discuss how much weight you hope to lsoe after surgery, how committed you are to a new lifestyle change, and other questions, so that you can make a more informed decision about which procedure is better suited to your needs.

When you are ready to take the next step, call us to schedule a consultation.

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