Individuals seeking to lose excess weight can achieve their goals through various methods and approaches. Among these options, obesity surgeries hold a significant place. However, obesity surgery itself is divided into different choices. When selecting the most suitable surgery from these options, there are several important points to consider and keep in mind. Below, you will find detailed information from different perspectives to help you make the most accurate choice. Each section provides insights that will assist you in selecting the most appropriate obesity surgery. Final decisions should always be made in consultation with a specialist doctor.
Sleeve Gastrectomy or Gastric Bypass?
Gastric bypass, one of the oldest methods among obesity surgeries, has been in use for over 40 years. When it first emerged in the 1980s, it was among the most preferred standard surgical methods. However, for individuals with severe obesity requiring a preparatory phase, sleeve gastrectomy was initially performed. This approach involved undergoing sleeve gastrectomy as a preparatory process, followed by gastric bypass surgery to achieve the final weight-loss goal. This sequential use of two different operations was preferred for about 20 years. In the early 2000s, advancements in technology and the analysis of extensive data accumulated over the past 20 years revealed that the outcomes of sleeve gastrectomy were almost identical to those of gastric bypass surgery. Following this discovery, sleeve gastrectomy alone was deemed sufficient and became the primary method chosen.
What Are the Technical Differences Between Sleeve Gastrectomy and Gastric Bypass?
Below are various headings that should be considered when evaluating the differences. By considering the risk levels, procedural details, post-operative processes, and both temporary and permanent effects, the distinctions between the two surgeries become clear.
Risk Level of the Surgery
When comparing the two different approaches, sleeve gastrectomy aims to reduce the stomach size by approximately 80% vertically. In sleeve gastrectomy, there is no intervention in the intestines. On the other hand, gastric bypass surgery involves both the stomach and the intestines, making it much more complex and requiring a longer process. The goal in surgeries is to achieve maximum results with minimal contact points. In gastric bypass surgery, not only the stomach but also the intestines are involved, making the procedure more intricate and multi-layered, thereby increasing the risk of complications, which is an undesirable outcome.
Procedural Details and Post-Operative Process
The primary goal of sleeve gastrectomy is to achieve weight loss by restricting stomach volume. Individuals who choose sleeve gastrectomy experience a reduced appetite and engage in less eating activity. To achieve this, the part of the stomach that stimulates appetite is removed. As a result, appetite-regulating hormones are not activated, and the individual is freed from constantly thinking about eating.
In gastric bypass surgery, in addition to the restrictive effects, there are also malabsorptive effects. Since the malabsorptive effect continues, individuals need to take vitamin and mineral supplements for life. In sleeve gastrectomy, there is no malabsorptive effect, which is both an advantage and a disadvantage. The advantage is that individuals do not need to take additional vitamin and mineral supplements. The disadvantage is that they may start to regain weight. In gastric bypass surgery, consuming high-calorie foods causes the small intestine to absorb them quickly or excessively, leading to discomfort known as dumping syndrome. Dumping syndrome primarily involves the risk of diarrhea and low blood pressure, directly affecting the individual’s comfort and daily life. Those who choose sleeve gastrectomy do not experience dumping syndrome.
Permanent and Temporary Effects
Individuals who opt for sleeve gastrectomy have their stomachs permanently reduced in size. This should be considered when making the decision. In gastric bypass surgery, no permanent stomach reduction is performed. Although rarely performed, theoretically, the procedures can be reversed. In gastric bypass surgery, the stomach is divided into two parts. The lower part is left closed within the abdomen and cannot be accessed via endoscopy. Eliminating the possibility of endoscopic access is an undesirable situation for the individual’s overall health and treatment of other diseases. In sleeve gastrectomy, even though the stomach is reduced in size, it does not prevent endoscopy.
In What Areas Is Gastric Bypass Obesity Surgery Successful?
Gastric bypass surgery is successful in specific conditions, notably metabolic diseases. For individuals with metabolic diseases, gastric bypass surgery is much more effective than sleeve gastrectomy. Among the most preferred groups for gastric bypass surgery are diabetic patients over 45 years old. Particularly, individuals with severe diabetes requiring insulin use may opt for this procedure.
It is also worth noting that sleeve gastrectomy is effective in addressing metabolic diseases. Individuals without insulin resistance may prefer sleeve gastrectomy to eliminate the need for oral medications.
Revision Surgery in Obesity Surgeries
Obesity revision surgeries may be performed for various reasons after initial obesity surgeries. These revision surgeries face restrictions based on the type of initial obesity surgery chosen. Since sleeve gastrectomy does not involve complex changes, revision surgeries are easier to perform. If necessary, sleeve gastrectomy can be revised to gastric bypass surgery. However, revision surgery after gastric bypass is both difficult and risky. Although theoretically possible, it is rarely preferred in practice. Young individuals considering obesity surgery should keep this in mind. Given the long-term considerations, opting for sleeve gastrectomy may be a more sensible choice.
Which Obesity Surgery Is More Successful?
Considering all the headings above, selecting an obesity surgery requires taking numerous factors into account simultaneously. There is no single key to a successful operation. Individuals can achieve successful results with either of the two different obesity surgeries. The crucial aspect is approaching the person’s health holistically when making a decision. Sleeve gastrectomy has a much lower likelihood of complications, which is one of the main reasons for its preference. A large proportion of those who opt for gastric bypass surgery are insulin users, for whom gastric bypass yields more successful results.
Both types of obesity surgeries have their own advantages and disadvantages. Evaluating these aspects separately to ensure overall benefit is the primary goal. In patient evaluations conducted by specialist doctors, it becomes largely clear which option is healthier. Individuals considering obesity surgery should not only focus on the type of surgery but also on the lifestyle changes and healthy living that will accompany the surgery.
Disclaimer: This information is intended for educational purposes only. Always consult a qualified healthcare provider for personal medical advice, diagnosis, and treatment regarding obesity or other health concerns.
