Gastric Sleeve Vs. Gastric Bypass

what is better gastric sleeve vs gastric bypass

People who are considering having weight loss surgery to combat obesity and related health conditions have several different procedures they can consider. With the many advancements in bariatric weight loss techniques over the past few years, there are now surgical options as well as non-surgical options available. Below is a comparison between traditional gastric sleeve vs. gastric bypass surgeries highlighting the success rates, benefits, risks, and pros and cons of each so you can make an informed decision if either may be right for you.


What Is the Difference Between Bariatric Sleeve And Bariatric Bypass?

Gastric sleeve and gastric bypass are the two most popular bariatric surgeries that have things in common but are done in a different manner.

During gastric sleeve surgery, 80% of the stomach is permanently removed. The surgeon then sutures the remaining portion into a small pouch or sleeve.

During gastric bypass or Roux-en-Y gastric bypass (RYGB), the surgeon creates a small pouch by bypassing most of the stomach and the part of the small intestine that absorbs most of the calories. The pouch is attached to the end part of the small intestine.

Gastric Sleeve Vs. Gastric Bypass Comparison Chart

Gastric Sleeve Gastric Bypass
Gastrointestinal Changes
Does not alter your digestive system Alters your digestive system
Surgical Technique
Performed laparoscopically unless otherwise medically necessary when it would be performed open Performed laparoscopically unless otherwise medically necessary when it would be performed open
BMI Requirements
BMI of 40+ or BMI of 35-39.9 and weight-related health conditions such as type 2 diabetes or high blood pressure, etc. BMI of 40+ or BMI of 35-39.9 and weight-related health conditions such as type 2 diabetes or high blood pressure, etc.
Pre-Procedure Requirements
Liquid diet is required by the surgeon before surgery. Pre-op diet restrictions range from 2 days to 2 weeks before surgery Liquid diet is required by the surgeon for 2 weeks before surgery
Time Length of Surgery
Average 1 hour and 40 minutes Average 2 hours and 45 minutes
Average Success of Weight Loss
60-70% of excess body weight lost within 12 to 18 months 50-80% of excess body weight lost within 12 to 18 months

Both of these bariatric procedures have been around for decades and both are well-known procedures that can produce significant weight loss in patients with relatively low-risk factors. Any surgery brings with it risks as well as pros and cons. It’s important to understand and consider these before making a commitment to any procedure.

Pros, Cons & Risks of Sleeve Vs. Bypass Chart

Gastric Sleeve Gastric Bypass
  • Potential to lose up to 80% excess body weight
  • Fewer calories absorb since bypassing the intestines
  • Lose weight faster
  • Difficult but can be reversed
  • Alleviation or reduction in health issues related to weight
  • Less weight loss compared to average with bypass
  • Slower weight loss
  • Permanent, cannot be reversed
  • Higher risk of complications because surgery is more complex
  • Longer recovery
  • Can lead to nutritional deficiencies
  • Dumping syndrome is common
  • More expensive
  • Stomach leakage at the staple line
  • Abdominal abscess
  • Constriction or twisting of the new stomach tube
  • Reflux, heartburn
  • Dysphagia, i.e. difficulty swallowing
  • Bowel obstruction
  • Bleeding gastrointestinal
  • Affects tolerance to alcohol
  • Intestinal ulceration/leaks
  • Infection
  • Perforation of nearby organs
  • Lung or breathing issues
  • Gallstones
  • Hernias

Who Is A Candidate For Bariatric Sleeve vs. Bypass?

For obese people either gastric sleeve or gastric bypass surgery would work to help them lose weight as long as they are committed to the process. There may be some slight advantages of one surgery over the other for different types of patients.

Gastric Bypass Candidates

Gastric bypass surgery is a more invasive surgery but it also helps patients lose between 10 and 20 lb more than the gastric sleeve procedure due to the way the digestive system is re-routed.

  • Patients who are experiencing extreme cases of diabetes may benefit slightly more with this weight loss surgery over gastric sleeve although both surgeries will alleviate and sometimes eliminate the symptoms of diabetes.
  • Patients who are suffering from severe reflux disease are often better candidates for gastric bypass.

Gastric Sleeve Candidates

Gastric sleeve surgery is less invasive than gastric bypass surgery and carries only a 3% risk for complications vs the 5% risk associated with the gastric bypass procedure. The surgery time is shorter as well as the recovery time so it may be better for patients who are intolerant to general anesthesia or individuals who are high-risk surgically speaking. Read our full article on what makes you a good candidate for a gastric sleeve procedure.

  • Patients who have had multiple abdominal surgeries and possibly scar tissue related to those procedures would be better candidates for gastric sleeve surgery. Scar tissues could inhibit the surgeon’s ability to re-route the digestive system during a bypass.
  • Patients that are severely obese, i.e. 450-500 pounds, would be better candidates for gastric sleeve surgery because their excess fat could limit the amount of space the surgeon would have to work within if attempting to re-route the digestive system through a bypass.
  • Individuals who are dependent on medication for psychiatric illness would be best served by gastric sleeve surgery vs gastric bypass. Bypass surgery can alter the way medications are absorbed and distributed through the body and may have an adverse effect on a patient who suffers from depression or anxiety.

What If You Are Not A Candidate For Either Gastric Sleeve Surgery or Gastric Bypass Surgery?

Sometimes patients are not candidates for bariatric surgery due to medical reasons, physical limitations, or BMI requirements. There is a procedure that can help these individuals lose weight without having to undergo the risks associated with a surgical procedure.

Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic Sleeve Gastroplasty or ESG is a non-surgical procedure that is performed through a special instrument that is lowered down the patient’s throat. This instrument, which resembles a thin flexible tube, is outfitted with a special tiny camera and also allows for the insertion of other special surgical instruments through the tube that are necessary to perform the procedure.

During the procedure, the surgeon uses a special suturing device to reshape the patient’s stomach into a small sleeve-like pouch held together by stitches. The patient’s stomach is reduced to about 25% of the original size, which helps keep the patient feeling “full” for a longer period of time, and forces the patient to eat very small portions during a meal. The physical results of ESG are very similar to that of gastric sleeve surgery but without the incisions and risks or complications of a surgical procedure.

Patients can lose a significant amount of weight with ESG without undergoing surgery. There is no hospital stay necessary and a short recovery time of a week to ten days.

If you are suffering from obesity and/or health issues related to your weight and are considering gastric sleeve vs. gastric bypass surgery contact IBI Healthcare Institute for a consultation today.

Every person is different and every surgery will not offer the same results to each patient so consulting with an expert bariatric surgeon would be the best first step. IBI Healthcare Institute is here to help answer your questions and provide you with detailed information, tailored to your circumstances, to help you make an informed decision.

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