The Sleeve Gastrectomy procedure, commonly referred to as the Vertical Sleeve Gastrectomy, Vertical Gastrectomy or the Sleeve, is a newer restrictive procedure where the majority of the stomach is removed leaving a long tubular structure from the esophagus to the small intestine. The procedure is technically simpler than a gastric bypass and does not bypass any of the intestinal tract. There is no foreign material left within the abdomen. The risk of nutritional deficiency is lower compared to operations that bypass part of the gastrointestinal tract.

The recovery time after the Sleeve Gastrectomy resembles that of the gastric bypass. Hospital stay is typically one night after surgery and most patients are able to go home the following day. Many patients who have sedentary jobs return to work within 2-4 weeks. Patients with jobs that require more physical effort may be out of work for 4-6 weeks.

What are the Pros/Cons of Gastric Bypass, Sleeve Gastrectomy and Adjustable Banding?

Even though all three are restrictive procedures and performed with laparoscopic techniques, there are significant differences. Each has its own distinct advantages and disadvantages.

Gastric Bypass involves rearranging the gastrointestinal anatomy using surgical staplers. (A small stomach pouch is created). The surgery lasts around two hours and usually requires two nights in the hospital. The weight loss after surgery occurs over one to two years Because most of the stomach and part of the small intestine is bypassed, patients are at risk for anemia and osteoporosis and must take vitamins and supplements for the rest of their lives. Because the stomach and small intestine is stapled and divided, there is a risk for leaking and bleeding at the staple lines.

Sleeve Gastrectomy does not involve rearranging the gastrointestinal anatomy, but does use surgical staplers similar to a bypass. A portion of the stomach is removed and it is not reversible. The surgery lasts around 60-90 minutes and requires one night in the hospital. The weight loss occurs after one to two years. Patients do not have the same risk of nutritional deficiency that is found after gastric bypass. Just like a gastric bypass that uses staples on the stomach, there is risk of leaking and bleeding at the staple lines. Since this is a newer procedure, it may be less likely to be covered by your insurance company.

Banding involves placing a silicone device around the top of the stomach. The device is connected by tubing to a port that is placed under the skin. There is no rearrangement of the anatomy. The surgery lasts around one hour and usually requires one night in the hospital, although some patients can go home the same day as surgery. The weight loss after Banding occurs over two to three years. By using a special needle to access the port, the band can be adjusted by adding or removing saline solution. The adjustment changes the opening in the stomach at the level of the band and, therefore, controls how much food can be eaten. Banding requires more frequent follow-up visits, where adjustments may be performed.

In summary, all three procedures, Bypass, Sleeve and Banding can provide good, sustained weight loss; however, you must adhere to a proper diet and exercise program in order to get the best results. Bypass and Sleeve result in faster weight loss, but there are more risks with the surgery itself. Banding is a less-invasive surgery, but it does require several adjustments to be performed after surgery.

There are many factors that will influence your choice of procedure including your medical history and insurance coverage. We strongly believe in allowing you to choose your operation after learning about all of the benefits and risks of each procedure.