Gastric Band or Gastric Sleeve: What You Need to Know

For some patients with obesity, diet and exercise alone simply do not provide the desired results. Some patients who have not been able to lose weight effectively with other methods might be candidates for bariatric surgery, a type of surgery designed to reduce the size of the stomach and encourage feelings of satiety to aid in weight loss.

If you are a candidate for weight loss surgery, you’re probably wondering which of the many options is right for you. Let’s compare two popular types of weight loss surgical procedures to see how they differ and what they may have in common.

Laparoscopic Adjustable Gastric Banding (Gastric Band)

Laparoscopic adjustable gastric banding (also called gastric band or lap band) is considered to be the safest bariatric surgery option. The procedure is minimally invasive and performed on an outpatient basis. The surgeon makes very small incisions using a laparoscope and places an adjustable band around the upper portion of the patient’s stomach.

Afterwards, the patient is only able to eat enough to fill this top part of the stomach. However, digestion proceeds normally as the food slowly passes down through the band to the lower part of the stomach. Overall, the gastric band makes the patient feel full faster and eat less.

The gastric band is not permanent; it is adjustable and can be removed. No part of the stomach or intestines is cut or removed. Adjustments to the gastric band can help manage some of the most reported side effects, like nausea or vomiting, though these are still rare overall and typically mild.

Vertical Sleeve Gastrectomy

The vertical sleeve gastrectomy (or gastric sleeve) is another common type of bariatric surgery. In this procedure, close to 80% of the stomach is cut and removed, with the remainder stapled together to form a “sleeve.” This new stomach, shaped a bit like a banana, holds about 20-25% of the volume of the original stomach. The gastric sleeve procedure is permanent and cannot be reversed. The procedure typically requires an overnight hospital stay.

With a smaller stomach, the patient eats less food, absorbs fewer nutrients and calories, and may also experience hormonal changes that result in a decreased appetite. Infection, bleeding, and rarely, a leak along the incision line in the stomach are possible risks. Patients may have to take vitamins and supplements for life.

Benefits of Both Procedures

Overall, both procedures are relatively low risk. They can not only help patients achieve their desired weight loss, but also improve the symptoms of several diseases and health problems related to carrying extra weight.

Patients may see improvement in symptoms of type 2 diabetes, hypertension, fatty liver disease, osteoarthritis, and sleep apnea, among others. Weight loss surgery can greatly improve the overall quality of life for the patient, improving their physical health, making it easier to engage in regular exercise and simple daily tasks, and improving their self-esteem.

Major Differences

Though both of these procedures result in weight loss, there are some key differences to consider when making a decision.

With a gastric band procedure, the device is completely adjustable and able to be removed for whatever reason. It is less invasive than the gastric sleeve procedure.

A vertical sleeve gastrectomy is not reversible. Because the procedure results in the permanent removal of most of the stomach, there is no way to reattach this in the future, and the results will be permanent, regardless of patient satisfaction.

In addition, because the gastric sleeve procedure affects the body’s ability to absorb calories and nutrients, patients need to stay on vitamin and mineral supplements, as well as follow specific dietary guidelines, for the rest of their life.

Patients with a gastric band have to adjust their eating habits—for example, eating more slowly and consuming smaller meals. However, they have less risk of vitamin and mineral deficiency.

Common Risks and Side Effects

As with any surgical procedure, both of these options come with the risk of complications and side effects. Complications and side effects are rare, but can include infection, bleeding, and heartburn.

With a vertical sleeve gastrectomy, surgical complications can also include leaking from the staple line or narrowing of the sleeve due to scarring. A few patients may experience dumping syndrome, which can result in vomiting, nausea, or diarrhea. This is when food moves too quickly through the reconfigured digestive tract, potentially causing serious gastrointestinal distress. With a gastric band, dumping syndrome is not a concern, since this procedure does not involve permanent surgical changes to the digestive system.

In general, the risk of complications for the gastric band procedure is lower than that for the vertical sleeve gastrectomy. Though both are very safe, the mortality rate for gastric band is lower than that for gastric sleeve: .006% compared to 0.2-0.3%.

The Bottom Line

In the end, the best weight loss procedure for you will depend on your health, your lifestyle, and your weight loss goals. Talk to your doctor to learn more.