Gastric sleeve is good for patients with extensive adhesions from a previous surgery in the abdominal area. Sleeve gastrectomy is also suitable for patients with ulcer history, taking aspirin, or smoking. Learn More
Gastric bypass is better for patients with severe acid reflux/GERD and slow metabolism. If patients have previously had Nissen fundoplication anti-reflux surgery, meaning the stomach is wrapped around the esophagus valve, then gastric bypass is the most appropriate. People requiring high amounts of insulin are better off with RNY bypass.
The notable difference between these two operations is that gastric bypass provides slightly more expected excess weight loss (%EWL) than the gastric sleeve and is better suited for the resolution of obesity-related health problems. On the other side, the RNY gastric bypass has higher rates of risks and more complications than the sleeve gastrectomy.
Gastric sleeve is less invasive than gastric bypass because there is no rerouting, or bypassing, and portion of the intestines. As a result of the malabsorption, essential nutrients and minerals are not absorbed by the body. Therefore, it is important to take vitamins and dietary supplements lifelong after gastric bypass.
There is a chance to stretch the new stomach (stoma) in gastric bypass and not so much in gastric sleeve as the pyloric valve stays intact. The possibility of a future revision surgery has many effective options for sleeve patients, although not so many for RNY patients.