The difference between Gastric Sleeve and Gastric Bypass

The difference between Gastric Sleeve and Gastric Bypass

Although one of the most common bariatric procedures today are gastric sleeve surgery, there is another surgery called the gastric bypass surgery.

There are commonalities between the two procedures, but there are also several key differences.

We will take a closer look at both procedures, what they entail, including both pros and cons, and when you may consider one versus the other.

What’s the difference between a Gastric Sleeve and a Gastric Bypass?

Both of these procedures reduce your stomach from its normal size to a smaller pouch. This reduction in stomach size causes weight loss in two main ways:

  • the remaining pouch fills up very fast so it limits the amount of food you can digest before feeling full
  • the hunger hormone known as grehlin, is reduced

The two procedures however differ widely in the way the new stomach pouch is formed.

Gastric sleeve surgery

With gastric sleeve surgery, 80 percent of your stomach is removed by the stomach in a minimally invasive way.

The remaining portion of the stomach is sewn into a small banana-shaped pouch. No further changes are made in the procedure.

Gastric bypass surgery

In this procedure, also known as the Roux-en-Y gastric bypass, a small stomach pouch is created by either removing, or “bypassing,” the majority of your stomach and the first part of the small intestine.

Then the newly created stomach pouch is then reconnected to the remaining part of the small intestine.

The bypassed part of the stomach is attached further down the small intestine, so it still provides the acid and digestive enzymes produced there.

The portion of your small intestine that’s removed with your stomach usually absorbs some nutrients and calories.

Since this area is bypassed, the absorption of those calories doesn’t happen, which helps with weight loss.

What is the difference in recovery time?

Gastric bypass is considered more complex than a gastric sleeve surgery. This is because a gastric bypass is a two-step procedure involving different anatomy, while the gastric sleeve only involves one step.

Both procedures are usually done in a minimally invasive way via a laparoscopic approach.

This involves inserting laparoscope (a lighted scope with a camera)  and other minimally invasive instruments through several small incisions made in your abdomen to perform the procedure.

If all goes well, a patient won’t experience a lot of pain postoperatively, and one should be able to keep liquids down. You’ll typically go home 24 to 48 hours after gastric sleeve procedure.

If one is experiencing a lot of pain after your gastric sleeve surgery, and can’t keep liquids down, or has other issues, they may need to spend an extra day or two in the hospital.

Because a gastric bypass is more complex, you’ll usually spend at least 48 hours minimum in the hospital, before you’ve recovered enough to go home.

One may need to stay in the hospital for a longer period of time if you one has complications after the surgery.

On the rare occasion, a minimally invasive surgery isn’t possible, so the surgery is performed open. This requires a larger incision in the abdomen. A larger incision takes longer to heal than the small laparoscopic incisions.

If you have open surgery, you’ll be in the hospital until your incision has healed enough for you to go home. This often means 5 or more days in the hospital.

Some of the reasons you might need open surgery include but are not limited to:

  • you’ve had previous surgery on your stomach in the past
  • you’re considered extremely overweight
  • you have significant medical issues in addition to being obese

Once you have been discharged from the hospital, you will need time to fully recover from the surgery. You’ll have to limit your activity for 3 or 4 weeks while your body heals before you can resume your normal activities.

What are the risks and complications?

Bariatric surgery is considered a relatively safe procedure.

According to the latest data from the American Society for Metabolic and Bariatric Surgery, the risk of a major complication is about 4 percent. This is certainly lower than the risk of developing serious  health complications from being obese.

Certain factors can complicate any surgery, including bariatric surgery, include:

  • blood loss
  • the formation of blood clots in your leg or your lungs (also known as a pulmonary embolism)
  • side effects from going under general anesthesia
  • developing an infection at the incision site
  • having pain postoperatively
  • developing pneumonia

Complications after bariatric surgery include:

  • gallstones
  • nutritional and vitamin deficiencies
  • having nausea, sweating, and diarrhea from eating too rapidly or eating sugary, fried, or fatty foods, or dairy (also known as dumping syndrome)
  • having saggy or loose skin

Complications from gastric sleeve surgery

Complications specific to gastric sleeve surgery are less but include:

  • acid reflux or (GERD)
  • stomach fluid leakage
  • narrowing along the stomach pouch (also known as stenosis)
  • stomach obstruction

Complications from gastric bypass surgery

Complications specific to the gastric bypass procedure include:

  • a much higher risk of having nutritional deficiencies due to the bypassing of your small intestine
  • sensitivity to alcohol
  • developing ulcers in the stomach
  • bowel obstruction
  • stomach perforation (hole in the stomach)
If you have struggled with weight loss and have considered surgery, we can help you achieve your goals. If you have any questions, feel free to call us anytime to schedule a consultation.

Contact Dr. Renfrow today to schedule your consultation.

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