Roux en Y Gastric Bypass vs Sleeve Gastrectomy
June 01, 2023
At the Denver Health Bariatric Surgery Center, we offer two options for bariatric surgery, the sleeve gastrectomy and the Roux en Y gastric bypass. Bariatric surgery is a good option for individuals who have been unsuccessful in trying to lose weight by other methods, such as diet, exercise, structured programs and diet medications. Our team is dedicated to the best outcomes for our patients and has helped thousands of patients in their journey to weight loss and better health.
How Does Bariatric Surgery Work?
There are two ways bariatric surgery works to help you lose weight.
The first (Sleeve Gastrectomy) is restrictive, meaning you have a smaller stomach, allowing you to only eat small amounts of food.
The second (Roux en Y Gastric Bypass) is mal-absorptive, meaning the surgeon makes the intestines shorter and fewer calories are absorbed from the food you eat.
Denver Health Bariatric Surgery Center patients can decide with their care team which surgery is best for them. The following sections explain each surgery better.
What is Sleeve Gastrectomy?
The sleeve gastrectomy is a restrictive surgery, which reduces the size of your stomach. We use laparoscopic techniques to remove approximately two thirds of your stomach. You are left with a narrow, banana shaped stomach. There is a hormonal effect after having a sleeve gastrectomy, where your body will feel fuller for longer, which also helps with weight loss.
Advantages of Sleeve Gastrectomy:
- Good weight loss
- Short recovery
Disadvantage of Sleeve Gastrectomy:
- Risk of developing acid reflux post-operatively – this happens in a small portion of patients and might require taking acid-reducing medications or further procedures
What is Roux en Y Gastric Bypass?
In Roux en Y gastric bypass, the stomach is made even smaller, your new stomach is now a one to two ounce pouch. The intestines are then rerouted, to bypass a large amount of your intestine. This surgery is both restrictive and malabsorptive. You have a small stomach and can only eat small amounts of food, and your intestine has been rerouted, so you don’t absorb as many nutrients from the food you eat. There are also hormonal effects after this surgery, that help with weight loss.
Advantages of Roux en Y Gastric Bypass:
- More weight loss than sleeve gastrectomy
- Hypertension and diabetes improve even before you lose a lot of weight
- Better long-term weight loss
Disadvantages of Roux en Y Gastric Bypass:
- Because of the risk of malabsorption of certain vitamins and minerals, you will have to take a bariatric formulated multivitamin for the rest of your life
- You can not use NSAIDs, such as Motrin or Advil/ibuprofen, as this puts you at higher risk of developing a marginal ulcer
- Life-long risk of internal hernias
How to Decide Which Bariatric Surgery is Best for You?
There are several instances where gastric bypass may be better than sleeve gastrectomy.
- If you have a BMI above 50 – after a Roux en Y gastric bypass, patients with higher BMIs have greater weight loss with gastric bypass compared to sleeve gastrectomy
- If you have severe GERD (gastro-esophageal reflux disease) – patients with mild GERD can have a sleeve gastrectomy; there is a small chance that their reflux might worsen
- Those with insulin-dependent diabetes – if you have severe diabetes and are on insulin, the Roux en Y gastric bypass may be a better surgery for you
This is ultimately a discussion between you and your surgeon. Both procedures have good weight loss outcomes and can help you achieve your health goals.