Two of the most popular bariatric surgeries are a gastric sleeve and gastric bypass.
In this article we are going to discuss the differences between gastric bypass and gastric sleeve surgeries; their performance methods, advantages, side effects, limitation and after surgery diets and lifestyles to be followed.
Surgeries are the ultimate option to get rid of excess body weight when all simpler slimming methods like fat loss diets, supplements, and workouts fail to produce the desired results.
If all your best efforts to lose weight have gone vain, certainly you should think of undergoing vertical sleeve gastrectomy or Roux-En-Y gastric bypass surgery. Morbidly obese conditions are life-threatening as it would soon pave the way for fatal diseases like type2 diabetes, stroke, cardiovascular diseases, and even cancer. It is good to undergo bariatric surgery than becoming a victim of fatal diseases that morbidly obese people usually suffer.
Methods Followed In Vertical Sleeve Gastrectomy And Gastric Bypass
Vertical sleeve gastrectomy (VSG), also called gastric sleeve, is the best choice for patients who are seriously ill or physically not fit enough to undergo radical bariatric operations.
VSG surgery can be used as a standalone surgery or in some cases the doctors may do this surgery first, and then after few months, full gastric bypass is performed if the patient is not achieved the desired weight loss results.[1,2]
The doctors make use of a laparoscope (a narrow tube equipped with a camera and light) to perform both these surgeries. Few minor incisions are made in the stomach just to insert the laparoscope and other tiny instruments into the abdominal cavity to make the adjustments in the stomach and intestinal bypass.
The stomach is divided into two parts in gastric bypass surgery. A small pocket or pouch is created in the upper part of the stomach. A new pathway is created by cutting through the middle of the small intestine and connecting it to the small pouch formed in the stomach. A bypass of the lower part of the stomach and upper part of the small intestine is created in this procedure.[5,6]
The gastric bypass surgery (GBS) shortens the digestive tract, whereby the calorie absorption from the food is drastically reduced.
It will take about 2 hours to complete the GBS procedure, and the patient will require about 2 to 3 months to get back to normal health.
The gastric sleeve surgery involves removal of three-quarters of the stomach. The size of the stomach is drastically reduced, and it takes the shape of a sleeve or tube.
The VSG does not change the gastrointestinal path. The food goes through the complete digestive tract. Usually, this surgery too will take about 2 hours to perform and about two months to fully heal the internal wounds.[9,10]
Results Of VSG And GB Surgeries
The VSG helps the patient to lose weight by reducing the amount of food which can be consumed at the time because of the reduced size of the stomach. The side part of the stomach (3/4) is fully removed. In VSG, an only small tube-like portion at the top of the stomach is left with little capacity for storing the food.
With the massive reduction in the food eating capacity, the patients who undergo VSG lose up to 70% total weight in 6 months to 2 years.
The result of gastric bypass surgery is much more profound on weight loss. In GBS not only the major portions of the stomach is closed, but also the food is made to bypass the major portions of the small intestine
A pouch created at the upper part of the stomach can hold only a little amount of food at a time. This makes the person feel full with the little amount of food intake. As the digestive tract is shortened by the bypass created, the body also does not absorb the extra amount of calories and fat.[14,15]
The weight loss result from gastric bypass surgery is much faster and profound than the vertical sleeve surgery but can cause a few health complications in some of the patients.
How Are The Patients Selected For GSV And GBS?
Generally, the weight-loss operation is usually performed on obese persons whose BMI is more than 40. However, bariatric surgery could be carried out on a person with a BMI score as low as 30 if the patient is suffering from diabetes mellitus, infertility and blood pressure due to the obesity conditions of the individual.
Doctors usually prescribe either of these surgeries depending upon the specific obesity condition and requirement of the patient.
The veridical sleeve is meant not only to reduce the bodyweight but also as a solution to treat the other obesity-associated diseases.
The patients who undergo GSV surgery or a duodenal switch could be recommended to undergo the GBS surgery after a few months or a year if desired weight loss results are not obtained from the first.
Gastric bypass is suitable for patients with a BMI score above 40. It is normally required for people who are not able to reduce weight with exercise, diet, and medication. This surgery may also be recommended for people who are suffering from life-threatening obesity-related diseases but not on persons with weak health.
The most effective bariatric surgery is the Roux-en-Y laparoscopic bypass surgery because it yields long term weight loss. However, it is the most invasive weight loss surgery that can lead to health complications in some of the patients.
Advantages Of Gastric Bypass And Gastric Sleeve Surgeries
Both of the surgeries in the discussion have advantages and disadvantages.
Here are some of the major benefits of Gastric Bypass Surgery:
- This is most effective among all the weight loss surgeries as it can help in reducing up to 80% of excess body weight
- The intake of the food is greatly reduced as the size of the stomach is reduced to a small pouch.
- It is effective for long-term weight loss results.
- It is possible to reverse the surgery and restore the original integrity of the stomach and food passage through the entire digestive tract.
- Restricted absorption of calories and nutrients promotes higher weight loss
Below given are the major advantages of Vertical sleeve gastrectomy:-
- This effectively reduces up to 60% of the excess body weight
- It is a less complicated process than bypass surgery.
- It suppresses appetite as the ghrelin hormone gland is removed through this surgery.
- VSG reduces the food intake as stomach size is reduced to the size of a sleeve or tube.
- Unlike gastric bypass surgery, it does not decrease the absorption of nutrients and vitamins as no bypass created and foods get digested as it happens in a normally healthy person.
- It keeps the small intestine and pyloric valve intact
- This surgery is good for people with a high BMI score above 50 or patients suffering from Crohn’s disease, anemia, prior surgery impact or anti-inflammatory medication
Risks, Complications, And Disadvantages Of Vertical Sleeve Gastrectomy And Roux-En-Y Gastric Bypass Surgery
There are some studies conducted to analyze the risks and disadvantages of both procedures. Both of these surgeries are good, and they have proven weight loss results too. However, there are a few disadvantages associated with both these surgeries as reported by various studies conducted. The major ones are as follows:
Drawbacks Of GBS
- As the length of the digestive tract is reduced, it causes a deficiency in the absorptions nutrients and vitamins.
- The frequency of defecations is increased (3 to 5 times a day) due to poor digestion of food.
- Causes Dumping Syndrome which causes diarrhea, vomiting and abdominal discomfort immediately after a meal and it may even cause fear of eating food especially in the out-of-home environment.
- The patient needs to follow a strict diet plan post-surgery period and has to give up many of the common foods.
- There are possibilities of bleeding, infection, and blood clots in the post-surgery period
- This method involves complex, an invasive surgical procedure
- This surgery may cause the development of an ulcer, gallstones, bowel obstruction and reflux.
Drawbacks Of VSG
- Loss of appetite can make the patient week by not eating sufficiently and frequently
- This surgery can also cause internal bleeding, infection and blood clots
- It can cause stomach leakage along the stapled edge
- It is irreversible and permanent unlike the GBS
Comparing Dietary Guidelines
Both surgeries require the patients to follow a well-planned daily diet.
The patient who underwent vertical sleeve gastrectomy requires:
- About 700 calories per day during the weight-loss period
- Diet should consist of five small meals; chewed into a pureed consistency.
- Snacking between the meals to be avoided
- Protein and nutrients rich food to be included in the diet
The patients who have undergone gastric bypass require:
- About 800 calories per day during the weight-loss period
- Should take three small meals per day
- Avoid high-fat and high-carb foods as well as fibrous, sticky, and dry foods that may cause blockage in the narrow intestinal bypass.
- Tough, bread, pasta, nuts and meat is not suitable for consumption
- Soft drinks and soda should be strictly avoided to prevent bloating
The Bottom Line
Bariatric surgeries have become the assured weight loss solution; more and more people are opting for the same.
Gastric Sleeve is proved to be gaining more popularity as it has fewer health complications in comparison to the gastric bypass. The sleeve surgery suppresses the appetite and reduces the food intake capacity by reducing the size of the stomach; but at the same time, it does not affect the digestive process and ensures the body receives all essential vitamins and nutrients.
Whereas gastric bypass surgery is excellent for maximum weight loss results as it not only reduces the food intake capacity of the stomach but also prevents the body from absorbing the excess amount of calories as a bypass is created to shorten the food digest tract. This surgery effects can be reversed to the original status of the stomach and food digestive tract after achieving the desired weight loss results.
However, gastric bypass surgery is complex and can have side effects that make the person’s life a bit difficult in the post-surgery period. It also hinders the proper absorption of essential vitamins and nutrients required by the body.
Finally, the weight reduction results got from both bariatric surgeries are not permanent; the patients can become obese again after several months or years after the surgery with changes in food habits or due to the onset of other diseases.