Bariatric Surgery Comparison

Updated: 5/25/24By Jason Richardson, MD

Bariatric Surgery Comparison

Today's main event is Band vs Sleeve, Band vs Bypass, and Sleeve vs Bypass

After studying bariatric surgeries for over a decade, we're not sure that there is a single best procedure for every patient. They each have their merits and their drawbacks, their staunch supporters and their haters. However, they are all powerful tools to help fight obesity. Your own medical history, lifestyle, and personal preferences play a huge role in choosing which one you want to help you.

We have prepared a comparison of some of the procedures and included some important pros and cons of each procedure. Try not to just count the number of pros or cons, because the elements are not always equal to each other in regards to frequency or seriousness. For example, band system leaks might occur more often than staple line leaks, but staple line leaks are usually far more serious.

Looking at lists of surgical risks can be frightening. However, remember that bariatric surgery is designed to help you treat obesity, and the risk of remaining obese can be devastating. Obesity may increase your risk for numerous health problems such as:

Diabetes

Fatty liver disease

Gallbladder and pancreas diseases

Heart disease

High blood pressure

Infertility

Osteoarthritis

Some cancers

Stroke

These lists are not exhaustive. There are other elements, some big and some small, that did not make our lists. For example, we did not include elements that were shared amongst all the surgeries (like infection risk), or mild effects (like the desire to take some time off work after surgery). We also did not include every bariatric surgery in existence, just some of the more common options. We hope that you can get a fuller understanding of these surgeries by reviewing these lists, but continue your own research and ask your surgeon for details.

Adjustable Gastric Banding

Pros

Adjustable

Removable

Avoids stomach stapling

Lower chance of complications that cannot be definitively treated with a single surgery

Cons

Risk of band slippage

Risk of band erosion

Risk of band system leak

Risk of port infection

Risk of stomal obstruction

Click here to learn more about this surgery

An adjustable gastric band located around the stomach.

Sleeve Gastrectomy

Pros

Increased average excess body weight loss

No need for adjustments

Lower risk of complication development after the first year of an uncomplicated course after surgery

Cons

Irreversible with risk of complications that cannot be definitively treated with a single surgery

Risk of uncontrollable reflux

Risk of staple line leak or bleeding

Risk of bleeding into the gastrointestinal tract

Risk of ulcer

Click here to learn more about this surgery

A sleeve gastrectomy. The portion on the right is removed from the body during the surgery.

Gastric Bypass

Pros

Increased average excess body weight loss

No need for adjustments

More likely to treat some forms of diabetes and reflux

Cons

Irreversible with risk of complications that cannot be definitively treated with a single surgery

Risk of internal hernias,  small bowel obstruction, strangulation, and necrosis

Risk of staple line leak or bleeding, including bleeding into the gastrointestinal tract

Risk of ulcer

Risk of fistula

Increased risk of excessive malnutrition and increased need for injected vitamins