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. Sleeve gastrectomy and RNY gastric bypass result in similar excess weight loss during the first 12 to 24 months. They also resolve a lot of comorbidities, such as diabetes type 2. Both procedures limit the amount of food you can eat. Sleeve operation makes you less hungry as bypass decreases the vitamins and minerals absorbed.
Gastric sleeve operation is less complex and invasive than gastric bypass. It has less chance of difficulties during and after surgery with fewer side effects. However, there are specific criteria for opting with the sleeve procedure rather than bypass. This guide will help you determine which surgery choice is most suitable for your circumstances.
Consult with MBC’s top-rated weight loss surgeons in finding out the best option for you!
Bypass Versus Sleeve Cheat Sheet
In deciding which is better bypass or sleeve, consider eight general factors,
- Sleeve with BMI < 45 and bypass with BMI > 45
- If you smoke, the sleeve is a better alternative
- If you take aspirin regularly, the sleeve is the way to go
- If you drink, bypass can increase the likelihood of alcoholism – go with the sleeve
- GERD/reflux can worsen with sleeve, so you need to go with bypass
- Bypass is more effective in curing diabetes type 2 – high insulin users need bypass
- If you have a previous fundoplication, bypass is the right one
- Sleeve if you have excessive scar tissues from previous abdominal surgery
We will show the pros and cons, similarities and differences, and long-term results you can expect for both Vertical Sleeve Gastrectomy (VSG) and Roux-en-Y Gastric Bypass (RYGB).
Which Procedure is Best for Me?
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.
Candidacy Requirements
Do I Qualify for Gastric Sleeve?
BMI 30+
Existing Abdominal Scarring
Previous Ulcer
Sleeve is Easily Revised
Smoker
Do I Qualify for Gastric Bypass?
BMI 35-55
Slower Metabolism
“Sweet Tooth”
- Barrett’s Esophagus
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.
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 in the United States is a difficult task and lengthy process. 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 $4,595 up to $24,000+. On the other hand, gastric bypass costs start at $5,995 and can go up to $27,000. Mexico Bariatric 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 are 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 the 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.