What is a Gastric Sleeve?
The Gastric Sleeve is so named due to the sleeve-like shape of the stomach after the surgery is performed. Approximately 85% of the stomach is removed, so the remaining stomach is shaped more like a tube or "sleeve". Gastric Sleeve surgery is a proven and effective method for helping patients suffering from obesity and weight-related conditions find a solution to their weight problems.

What are the Benefits of the Gastric Sleeve?
Gastric Sleeve surgery is considered much safer than more invasive surgeries like Gastric Bypass and Duodenal switch. There is also no malabsorption of nutrients as the Gastric Sleeve is an entirely restrictive process and all nutrients are absorbed from the food you eat. The amount of weight loss is also significant and comparable to other weight loss surgeries, with some reports stating loss of up 30-50% excess weight within the first 6-12 months. Unlike the Gastric Banding procedure, there is no need for strict follow ups and adjustment of the band.

What is involved in a Roux-en-Y gastric bypass procedure?
Roux-en-Y gastric bypass is the most commonly performed bariatric procedure. This method makes the stomach smaller and alters digestion. It is referred to as a combined restrictive and malabsorptive procedure because less food can be eaten and fewer calories can be absorbed.

What does gastric bypass do?
First, the stomach is cut to create a very small upper pouch and a larger lower pouch and second, the small intestine is cut. The more distant portion of the small intestine is connected to the small stomach pouch. Initially, this pouch holds about an ounce of food, causing a feeling of fullness after consuming a very small amount. In time, the pouch stretches to hold about one cup of food at each meal. The remaining larger lower stomach pouch, which does not receive food anymore, is sutured to the small intestine and is needed to deliver digestive juices and hormones. Since food bypasses the majority of the stomach, as well as the upper small intestine, the body absorbs fewer calories from the food. Gastric bypass decreases appetite and improves metabolism by altering the release of various hormones.

How much weight will I lose after bariatric surgery?

Weight loss is variable from patient to patient but on average you can expect to lose 65-70% of excess body weight following Roux-en-Y Gastric Bypass surgery, 55-60% following Sleeve Gastrectomy and 35-45% of excess body weight following Laparoscopic Gastric Banding.

How is Adjustable Gastric Banding different from Gastric Bypass (Roux-en-Y)?

Laparoscopic Gastric Banding is a purely restrictive procedure. A silicone band is placed around the upper portion of the stomach to produce a small pouch that produces a feeling of fullness and prevents the desire to eat excessively. This procedure limits the amount of food that can be eaten but does not affect the absorption of vitamin and minerals. 

Roux-en-Y is a combination restrictive and malabsorptive procedure. A small pouch is formed at the upper portion of the stomach as in the gastric band but this pouch is surgically created(permanent) and the remained of the stomach and the first part of the small intestine (duodenum) is bypassed which causes malabsorption (fewer calories are absorbed for several months following the surgery). This combination procedure results in rapid weight loss and requires life long daily replacement of vitamins and minerals to prevent deficiencies.

Which weight loss procedure is less invasive?

All procedures are done laparoscopically which means usually 5-6 small incisions about one inch in length are made on your abdomen. This results in less pain, minimal scarring, and a much faster recovery. The laparoscopic gastric banding is less invasive than the gastric bypass because a silicone band is used to form the new stomach pouch. The gastric bypass pouch is surgically formed. The gastric band however requires adjustments. This means a needle is placed through your skin to a port where fluid is inserted or removed to provide adequate feeling of satisfaction to prevent excessive eating. The gastric band requires more frequent follow up visits (usually every 6 weeks) over the first few years.

What is the recovery time following surgery?

For both procedures you are generally up and walking on the first day. The day after surgery you are able to begin a liquid diet. For most individuals pain is well controlled with liquid oral pain medication after the first day. Those who have gastric bands are usually discharged on the day following surgery. Those who have had gastric bypass are usually discharged on the second day following surgery. After a gastric band you return to normal activities and back to work within 7 to 14 days. Those undergoing gastric bypass return to normal activities and back to work within 2 to 4 weeks.

Does my insurance cover weight loss surgery?

Most insurance companies have determined weight loss surgery to be a covered benefit for obesity and obesity related co-morbidities. We encourage you to contact your insurance provider to determine if weight loss surgery is a covered benefit under your policy and to see if they have any additional criteria. Insurance providers are changing their individual criteria for weight loss surgery at least every enrollment period. Please check with your provider frequently to see if their criteria have changed.

How often am I required to see the surgeon and dietitian after surgery for follow-up?

Following gastric bypass you will see the surgeon and dietitian at 2 weeks and 2 months. You will then see the dietitian at 6 months, 12 months and annually. You can schedule additional appointments with our dietitian, as you feel you need.  Following gastric band, you will see the surgeon and dietitian at 2 weeks and 6 weeks, then you will see the surgeon every 6 weeks for band adjustments for the first couple of years until your band is tight enough to allow for sufficient weight loss. You can schedule additional appointments with our dietitian, with your adjustments.



For further information, please refer to the following websites:




The British Obesity Surgery patient association

Association of Laparoscopic Surgeons of Great Britain and Ireland

Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland

British Obesity and Metabolic Surgery Society

Association of Coloproctology of Great Britain and Ireland

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