Comparing the various methods of weight loss surgery can help you determine which surgical approach is the best option for you. As weight loss surgery is only a tool to weight loss, what works best for one individual is not necessarily what will work best for another individual.
The following chart is a side-by-side comparison of two restrictive bariatric procedures, laparoscopic adjustable gastric band (LAGB) surgery (with either a LAP-BAND or REALIZE Band) and laparoscopic sleeve gastrectomy (LSG), also called gastric sleeve surgery. The information is meant to provide you with a general overview of these two methods and help you compare similarities and differences.
While it is important to be an informed patient, self-education should complement and not replace a consultation with a bariatric surgeon to discuss specific health needs and determine which surgical approach is best suited to your personal situation.
| Weight Loss Procedure |
Laparoscopic Adjustable Gastric Band |
Gastric Sleeve |
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| Approach to Weight Loss |
Restrictive
- Limits amount of food that can be eaten
- Slows digestion
- Creates satiety
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Restrictive
- Limits amount of food that can be eaten
- Reduces hunger sensations
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| Anatomy Changes |
Stomach
- Creates a new small (1-2 oz) stomach pouch by placing an adjustable silicone band around top part of stomach
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Stomach
- Reduces stomach size by removing 60% to 80% of the stomach along the greater curvature, leaving only a narrow tube
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| Dietary Guidelines |
- 800 calories per day during weight loss period (2-3 years)
- 1000-1200 calories per day, once goal weight is achieved
- eat protein-rich foods
- avoid fibrous, dry, or doughy foods as they can get stuck if eaten
- avoid high fat and high calorie foods
- drink 6-8 cups of water a day
- avoid carbonated drinks
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- 600 to 800 calories per day during weight loss period (1-2 years)
- 1000-1200 calories per day, once goal weight is achieved
- eat protein-rich foods
- avoid high fat and high calorie foods
- drink 6-8 cups of water a day
- avoid carbonated drinks
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| Eating Habits |
- eat 3 small meals a day
- avoid snacking
- no drinking with meals
- eat slowly and chew food thoroughly
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- eat five small meals a day
- avoid snacking
- do not eat and drink at same time
- chew food thoroughly
- do not lay down or rest horizontally after eating
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| Nutritional Supplements |
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- Multivitamin
- Calcium
- Vitamin B12
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| Operating Time |
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| Hospital Stay |
- less than 24 hrs - overnight
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| Time off Work |
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| Recovery Time |
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| Surgery Method |
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| Adjustable |
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| Reversible |
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| Medical Implant |
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| Surgery Risks and Disadvantages |
- General surgical risks including infection
- Band slippage (<5%), band erosion (<1%), or port problems
- Stoma obstruction
- Band needs fills and adjustments by doctor
- Requires more patient effort for initial weight loss than with gastric bypass or duodenal switch
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- General surgical risks, including blood clots, bleeding, infection, and pneumonia
- Leakage at stomach suture/staple edge
- Not reversible
- Requires more patient effort for initial weight loss than with gastric bypass or duodenal switch
- ASMBS has not recognized the sleeve as an accepted primary operation
- Most insurance companies consider it experimental and do not approve coverage
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| Surgery Benefits and Advantages |
- Simple and relatively safe procedure
- Reversible
- Adjustable
- Does not remove or alter any part of the stomach or intestines
- Short hospital stay
- Quick recovery period
- Low malnutrition risk
- Low rate of major complications
- Patient support programs offered by band manufacturers (My LAP-BAND Journey and REALIZE mySUCCESS)
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- Does not require a medical device implant into body
- Pyloric valve and small intestine are kept intact
- Reduces hunger (the portion of stomach that produces Ghrelin, the hunger stimulating hormone, is removed)
- Option for patients who do not qualify for band or bypass
- Few food intolerances
- Low malnutrition risk
- May be converted to gastric bypass or duodenal switch for additional weight loss
- Revision option for gastric band patients
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| Average Weight Loss |
- Slow and steady rate of weight loss
- Settles at final weight 3-4 years after surgery
- 40-50% weight loss after 1 year
- 55% weight loss after 5 years
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- Quicker rate of weight loss
- Short term results primarily favorable, especially in low BMI patients (BMI 35 - 45)
- 7Expected weight loss 60% to 70% of excess weight at 2 years
- Long term results not yet available
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