Weight loss surgeries, which are also collectively referred to as bariatric surgery are done when dietary and exercise treatment plans fail to work. More often, patients undergo this kind of surgery if their health is at risk due to their heavy weight. A bariatric operation can be done to obese adolescents and adults.
Gastric bypass and gastric sleeve are similar bariatric procedures. Several things are needed to be considered when deciding between gastric bypass surgery and gastric sleeve as both procedures are permanent. Both can also reduce hunger and can yield the highest number of weight loss.
Patients who undergo any of the two procedures are expected to stay in the hospital for two to three days. Both operations also lessen the amount of food that people can eat before they feel full. However, their methods differ.
Gastric Bypass Surgery vs. Gastric Sleeve
Gastric bypass surgery involves the making of a small pouch in the stomach to limit food intake and the creation of bypasses of the small intestine to cause a reduced ability to absorb nutrients and calories. It is the most common technique of weight loss surgeries.
During a gastric bypass surgery, a small pouch is created at the top of the stomach. This pouch will be the new and smaller stomach. The small intestine is then cut and will be connected to the new pouch. With this procedure, the food will now travel from the new stomach to the middle segment of the small intestine. Thus, the lower portion of the stomach and upper segment of the small intestine are bypassed. Lastly, the upper portion of the small intestine is attached to the middle segment of the small intestine. This path allows digestive fluids to move down the upper segment of the small intestine and into the middle segment.
With gastric bypass, there is rapid weight loss where sixty to eighty percent of excess weight is expected to be lost within 12 to 18 months after surgery. The recovery time for gastric bypass is about two weeks.
The benefits of gastric bypass surgery include:
- Long-term weight loss
- Decreased incidence of illnesses related to obesity such as diabetes, sleep apnea, and high blood pressure.
- Improved mood and quality of life
Gastric sleeve on the other hand, is a procedure where part/s of the stomach is/are removed, and then involves a creation of a sleeve (tube-shaped stomach). Gastric sleeve is also called as vertical gastric sleeve or weight loss sleeve. This procedure is usually an option for those people who are not qualified to have other bariatric procedures.
During a gastric sleeve surgery, several small incisions on the abdomen are made to be able to insert the laparoscope. A laparoscope is a tool with a tiny camera and light attached on its end that can send images to a monitor. About three-quarters of the stomach will be removed during the procedure to give way to the creation of a new stomach. The sleeve that is made covers the initial distance from the esophagus to the small intestine, while the pyloric valve continues to work normally.
Unlike gastric bypass surgery, weight loss is slower after a gastric sleeve operation. Fifty to eighty percent of the patient's excess body weight is expected to be lost within 12 months after surgery. The recovery time for gastric sleeve surgery is about two to four weeks.
With gastric bypass surgery, there is a risk of developing the "dumping syndrome," which is also called as rapid gastric emptying, while there is no risk of the dumping syndrome in a gastric sleeve operation. Dumping syndrome is a set of symptoms that are characterized by abdominal discomfort, weakness, and in some cases, abnormally quick bowel evacuation, which occur after meals in patients who had a gastric bypass surgery. Dumping syndrome also happens when huge volumes of food in the stomach quickly move through the small intestine usually after eating high in fat and sweet foods.
Dumping syndrome can lead to:
Other Weight Loss Surgeries
This type of weight loss surgery is a form of gastric bypass and is considered as the most common technique of gastric bypass operation. It is a procedure that is not reversible. Roux-en-Y works by reducing the quantity of food a person eats in a single sitting while decreasing nutrient absorption.
During surgery, the surgeon cuts at the top of the stomach that seals the rest of the stomach. This pouch will then be able to hold just an ounce of food. A cut will then be made in the small intestine and will be sewn directly to the pouch. With this procedure, the food will enter directly into the middle part of the small intestine, bypassing most of the stomach and the first part of the small intestine.
Biliopancreatic Diversion with Duodenal Switch
This procedure involves removing eighty percent of the stomach, while the pyloric valve, which is the valve responsible for releasing food to the small intestine, and a limited segment of the small intestine (usually the duodenum) are spared.
The procedure bypasses most of the intestine by attaching the end part of the intestine to the duodenum near the stomach. Thus, the name biliopancreatic diversion with duodenal switch. This is the type of surgery that restricts how much a person eats, as well as lessens the absorption of nutrients.
Although effective, this procedure has more risks, which include vitamin deficiencies and malnutrition. Biliopancreatic diversion with duodenal switch is commonly performed to people with a body mass index (BMI) that is greater than 50.
Laparoscopic Adjustable Gastric Banding (LAGB)
In this type of gastric surgery, an inflatable band around the upper portion of the stomach is positioned. This band acts like a belt that tightens and compresses the stomach when inflated. The band also divides the stomach into two regions. A very small upper pouch communicates to the rest of the stomach by means of a channel made by the band. The band is adjustable so that it can restrict more or less food.
Laparoscopic adjustable gastric banding is a more common weight loss procedure because of its simplicity. However, LAGB may result in a lesser weight loss compared to other procedures, and the band may need to be adjusted every now and then.
Vertical Banded Gastroplasty (VGB)
Similar with LAGB, vertical banded gastroplasty also divides the stomach into two parts that limit the food to be consumed. A small upper pouch empties into the rest of the stomach, which is the lower pouch. This type of weight loss surgery is not that popular because it does not lead to adequate weight loss in the long run. This gastric procedure is also commonly known as stomach stapling.
All weight loss surgeries use general anesthesia. This puts the patient unconscious while the procedure is ongoing, which typically takes about several hours. Each type of weight loss surgery has its own advantages and disadvantages. The type of weight loss surgery will depend on the individual’s specific condition. Factors such as eating habits, body mass index (BMI), previous surgeries, health problems, and possible risks of each procedure will be considered before arriving at the final treatment plan.