To determine which bariatric surgery is the most suitable option for you, you must discover how patients’ success varies with the type of surgical treatment. This guide compares two distinct procedures: the newer mini-gastric sleeve and not-so-new mini-gastric bypass.
The two procedures share the word “mini”, however, they are far from each other regarding eligibility and outcomes:
- The mini-gastric sleeve is a miniature version of the traditional gastric sleeve surgery.
- The mini-gastric bypass is not a scaled-down version of Roux-en-Y gastric bypass surgery.
Overall, the mechanism that produces weight loss is fundamentally different for both surgeries: Mini bypass has a predominant malabsorptive component as well as restrictive while mini-sleeve is purely restrictive.
Patients can expect an average of 80% of excess weight loss in two years with the mini bypass whereas mini sleeve patients can realize an average of 35% of excess weight loss in the same period.
Mexico Bariatric Center® is the pioneer in offering weight loss procedures, including mini-gastric sleeve, in Mexico.
Cheat Sheet: Mini Bypass versus Mini Sleeve
- BMI of 35+ should consider mini bypass.
- Mini bypass increases the chance of bile reflux.
- Mini sleeve may worsen GERD and acid reflux.
If you have a lot of weight to lose and struggle to follow an active lifestyle, the mini gastric bypass is the best primary or secondary revisional option. Mini gastric sleeve is optimal for those needing a kick-start in their diet journey.
Mini Gastric Bypass
Mini gastric bypass, known as “One-Anastomosis Gastric Bypass” or “Loop Bypass,” is an obesity intervention procedure that mobilizes the stomach to form a new gastric pouch, approximately holding 2 to 3 ounces. Loop bypass has a malabsorptive element through intestinal modification to alter micronutrient absorption. The reduction of the stomach promotes early satiety and the rerouting of small intestines creates minimal calorie secretion into the body.
Mini gastric bypass granted less rigorous technical complexities and is faster and easier operatively, yet have similar weight loss compared to RNY gastric bypass due to the strategy for only one anastomosis.
Mini Gastric Sleeve
Mini Gastric Sleeve, known as the “loose sleeve,” is a minimized version of the traditional gastric sleeve also called Vertical Sleeve Gastrectomy (VSG). Instead of 80-85% of the stomach, only 35-55% of the stomach along the greater curve is cut and stapled sealed. It works the same way as a gastric sleeve by reducing the urge to eat and limiting the amount of food intake.
The total operative time is 45 to 60 minutes while the patient is under general anesthesia. Approximately 1 to 5 laparoscopic incisions are made across the abdomen to lift the liver and perform gastric resection. The loose sleeve is minimally invasive, although wider than the original gastric sleeve (known as “tight sleeve”).
The traditional gastric sleeve is performed through 3-5 incisions, however, the mini-gastric sleeve can be easily resected through one single incision. Instead of removing 80% of the stomach. This procedure is a man-made approach to obesity intervention that is not approved by the bariatric community.
Which Procedure Is Right For Me?
The mini-gastric bypass is a much more effective weight loss procedure that provides higher amounts of body fat loss. The key behind this success is the rerouting of the intestines. Known as anastomosis, the stomach uses a single connection directly to the small intestine.
The mini-gastric sleeve is a much less complicated and less invasive procedure that works best for someone whose BMI levels are not too high as it could provide better weight loss results. The mini-gastric sleeve is known as a safe, base surgery that can easily be reexamined for revision in the future.
 |  |
|---|---|
| Minimum BMI of 35+ | Minimum BMI of 29+ |
| Noninvasive procedure | Noninvasive & quicker recover time |
| Some intestine rerouting | No Intestine rerouting |
| A single connection to intestines (Anastomosis) | Easily revised |
Which Surgery Do I Qualify For?
Do I Qualify for Mini Bypass?
- BMI 35-55
- Severe Acid Reflux or GERD
- Slower Metabolism
- “Sweet Tooth”
- Barrett’s Esophagus
Do I Qualify for Mini Sleeve?
- BMI 30+
- Existing Abdominal Scarring
- Previous Ulcer
- Loose sleeve is Easily Revised
- Smoker
What is the Biggest Difference?
Even Google often struggles to distinguish between the two bariatric operations. Both procedures are performed laparoscopically, which makes them both minimally invasive surgeries. However, they are fundamentally different. This can seem confusing for someone looking to lose weight rapidly and permanently. The gastric mini sleeve does not involve any changes in the anatomy of the intestines as it only affects the size of the stomach.
- Mini gastric bypass is restrictive and malabsorptive: You eat less and fewer calories absorbed
- Mini gastric sleeve is restrictive: You eat less and get less hungry
Table Comparison of Mini Bypass versus Mini Sleeve
Mini Gastric Bypass | Mini Gastric Sleeve | |
|---|---|---|
| Method | Restrictive & Malabsorptive | Restrictive |
| Stomach | New Pouch: Stoma (2-3 oz.) | Remove 40-50% (1-2 oz.) |
| Anatomy | Bypass/Reroute Single Anastomosis | No change |
| Duration | 1.5 – 2 hours | 30 min |
| Hospital | 2 to 3 days | 1 to 2 days |
| Time Off | 2 to 3 weeks | 5 – 10 days |
| Recovery | 3 to 4 weeks | 2 to 3 weeks |
| Advantage | Single Connection Higher %EWL More Effective | Fewer complications Quicker recovery time |
| Disadvantage | Dumping Syndrome Hard to Revise Not Reversible Leak, Bleed, Vomit | Newer Non-FDA approved Less %EWL |
| Weight Loss | 65-84% EWL* | 20-40% EWL* |
| Post-Op | 3 to 5 Meals/Day Avoid Sugar and Fats Vitamin Supplements | 3 to 5 Meals/Day 800-1200 Cal High-Protein |
| Cure Rate | T2DM: 68% HTN: 45% GERD: 56% OSA (CPAP): 77% | T2DM*:TBD HTN*: GERD*: OSA (CPAP)*: |
| Candidacy | BMI of 35+ “Sweet Tooth” Severe Acid Reflux Diabetes | BMI of 29+ “1st” Procedure |
* There is no long-term data for mini-sleeve surgery
Conclusion
Each surgical procedure for obesity treatment provides a specific weight loss efficacy. The mini-gastric sleeve requires no alteration of the intestinal tract since it shrinks the stomach size and is considered a restrictive surgery. The mini-gastric bypass decreases the length of the small bowel and shortens the digestive process since it relies on malabsorption due to the single anastomosis.
If you are disciplined and can follow a strict diet and exercise regime, you can do well with a mini sleeve. If your BMI is higher than 35+, the mini-gastric bypass can provide higher amounts of weight loss. Whether you want to lose some pounds or completely resolve obesity-related health comorbidities, both surgeries can provide beneficial outcomes.
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