Gastric Sleeve Surgery vs Gastric Bypass Surgery
Choosing between gastric sleeve or gastric bypass is a huge decision to make, as the implications will affect the future of your life. It’s important to know exactly what you are signing up for when determining which surgery option is best for you.
Here we will show the pros and cons, similarities and differences, and long-term results you can expect for both gastric sleeve and RNY gastric bypass.
Which Procedure is Best for Me?
Gastric sleeve is good for patients with extensive scars from a previous surgery in the abdominal area. Sleeve is also suitable for patients with ulcer history, taking aspirin, or smoke.
RNY gastric bypass is better for patients with severe acid reflux and GERD. Patients with slow metabolism are better off with gastric bypass. Also, if patients have previously had gastric fundoplication surgery, meaning the stomach is wrapped around the esophagus valve to control acid reflux, then gastric bypass is the best option for them.
Candidacy Requirements
Do I Qualify for Gastric Sleeve?
BMI 30+
Existing Abdominal Scarring
Previous Ulcer
Sleeve is Easily Revised
Do I Qualify for Gastric Bypass?
BMI 35-55
Slower Metabolism
“Sweet Tooth”
What is the Biggest Difference?
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.
Table Comparison of Sleeve versus Bypass
Statistics show that since 2005, sleeve gastrectomy and Roux-en-Y gastric bypass have been the most widely requested and effective treatments of morbid obesity and type 2 diabetes mellitus. Gastric Bypass Surgery, once known as the “gold standard”, accounted for 80% of all bariatric procedures performed in the United States. Today, Gastric Sleeve Surgery accounts for over 90% of all weight loss surgeries performed across the country.
Comparing Costs and Insurance Coverage
Having insurance to cover for weight loss surgery is a difficult process in the United States. You should first make sure your doctor agrees with your decision to get bariatric surgery. Then, speak with your insurer to see if you have coverage for gastric sleeve surgery or gastric bypass surgery. If you have insurance coverage, it generally takes about one year to be approved – after a long pre-op diet, check-ups, classes, psychologist, and nutritionist meeting.
Depending on location, gastric sleeve costs range from about $4,500 up to $24,000+. On the other hand, gastric bypass costs start at $5,795 and can go up to $27,000. Mexico Bariartic Center can help you decide which surgery is best for you quick and hassle-free. Just take a few minutes to do the health application.
Sleeve vs Bypass Cost Comparison
Complications and Side Effects
Digestive Tract and Anatomy
The new stomach is like a hot dog or a “sleeve” and has the same shape as the duodenal switch pouch but smaller. With vertical sleeve gastrectomy surgery, there is no anatomical changes, no changes to the pyloric valve, and no intestinal bypass.
The gastric sleeve surgery significantly restricts the volume of food that can be eaten. The mixing of food with bile and pancreatic enzymes occurs as before surgery with no changes. Therefore, there is no malabsorption of nutrients, dumping, or bowel movements.
The new stomach is a small pouch and is connected to the small intestine where food and digestive juices are separated for the first 3 to 5 feet. The RNY significantly restricts the volume of food that can be eaten.
The delay in mixing of food with bile and pancreatic enzymes induces a moderate fat and protein malabsorption as well as calcium, iron, and B-complex vitamins absorption reduction. The alterations in the intestine also change the bowel movements: different smells, more gas, and occasional cramping.