If you’re considering weight-loss surgery, you’ve likely done some early research and run into a few options for the procedure. There are several kinds of bariatric or metabolic surgery, and while the end goal is the same, they have their own pros and cons. Today, in the interest of accurate information, we’re covering the three most common types of weight-loss surgery.
Laparoscopic Sleeve Gastrectomy (LSG)
Today the most common procedure performed goes by the name of the sleeve procedure. Originally called the vertical sleeve gastrectomy, the description came from the choice that surgeons had to make many years ago when removing part of the stomach due to a tumor or an ulcer, namely whether to make a horizontal cut or a vertical cut. The vertical cut was less common but was known to work quite well in case is that involved the need to remove the outer part of the stomach. What was it left behind was a banana shape stomach that was more slender and smaller than the original stomach but worked the same way and did not involve any re-routing or bypassing. The new stomach could look a bit tubular, which in the imagination of surgeons meant it looked like a jacket sleeve. Hence the name vertical sleeve gastrectomy. Today, the most common acronym one finds is LSG or laparoscopic sleeve gastrectomy.
The second most performed procedure in the United States is the one most people have heard of: gastric bypass or what surgeons refer to as Roux en Y gastric bypass. It involves creating a small stomach pouch and bypassing the remainder of the stomach by connecting the intestine to the stomach pouch. There are variations of the gastric bypass including something called a “loop” or (in a bit of marketing effort) a “mini” gastric bypass which works very similarly.
The third procedure is more of a distant third, representing a few percentage points of the overall procedures, and that would be something called duodenal switch. In recent years, this type of bypass has an alphabet soup of names that all have in common creating a bypass that starts from the duodenum, which is the very first part of the intestine right after the stomach. It usually has a sleeve gastrectomy as part of the overall procedure.
Which Procedure is Right for You?
All these procedures create their favorable weight loss, diabetes reversal, and overall health risk reductions by changing the hormone profile that regulates body weight, metabolism, blood sugar, and fat storage. Each of them exerts this effect slightly differently, creating a different profile among the family of these metabolic hormones.
Each of these procedures has a different profile of pros and cons or risks and benefits. Today, most people choose the sleeve procedure because of its safety and simplicity. The list of side effects and complications is the lowest for this procedure.
Gastric bypass remains popular as a second choice and as a second chance revision procedure if the sleeve failed to maintain long term weight loss. It has improved over the years as our knowledge of the science of this hormone family has improved, creating very durable long-term results that statistically outpace the weight loss and blood sugar numbers compared to the sleeve.
Lastly, duodenal switch is growing in popularity but remains a third choice. It too creates the most durable change in the hormone family that keeps weight blood sugar down. Both the duodenal switch and the gastric bypass bring more potential side effects, the cost of more durable effectiveness. Many people embrace the idea that the less invasive sleeve is the procedure of choice at first, but if needed, these back-up options of gastric bypass or duodenal switch can serve as a great second step when needed.