VA Boston Healthcare System
The surgeries we perform:
Here at the VA Boston, we perform 2 weight loss surgeries – The Roux-en-Y Gastric Bypass and the Sleeve Gastrectomy. Both of these surgeries are typically performed laparoscopically and are minimally invasive. When you meet with one of our surgeons, they will discuss with you the pros and cons of each surgery, and based on your medical history the surgeon may recommend one surgery over another.
Please remember that both procedures are a TOOL to help you in your weight loss journey and that if you do not make changes to your diet and lifestyle you may regain some or all of your weight. We do not offer the Laparoscopic Adjustable Gastric Banding (Lap Band) surgery as an option, but we can follow you as a patient for your post-operative Lap Band follow up appointments if you had this surgery at an outside hospital.
Table Comparing Roux-en-Y Gastric Bypass vs. Sleeve Gastrectomy
|Roux-en-Y Gastric Bypass||Sleeve Gastrectomy|
How is the surgery performed?
|Creates small pouch in stomach using surgical staples and bypasses part of the small intestine||Creates a small stomach by stapling off and removing about 80% of the original stomach|
|How long does the surgery take?||Usually about 2-4 hours||Usually about 1-2 hours|
|How does the surgery change the path of food?||Pouch is connected directly to small intestine; patient no longer uses the remainder of the stomach for food||Does not change path. Food just enters a smaller stomach but it proceeds through the digestive system as food did prior to surgery|
|How quickly do patients get back to work?||Usually two weeks for a desk job and up to four weeks for a manual labor position||Same|
|How do patients lose weight?||The newly formed small pouch limits the food that can be consumed and limits absorption of some calories. Also works hormonally to decrease appetite.||The food is going into a smaller stomach so the patient becomes full quicker and eats less food. Also works hormonally.|
|How quickly do patients lose weight?||Average of 10 pounds per month or more; usually, reach goal within 18 months of surgery. Can expect decrease in BMI of about 15 points.||Weight loss is not as rapid or severe as the gastric bypass patient. Can expect decrease in BMI between 8-12 BMI points.|
|Special considerations||Nutritional supplementation is imperative because some nutrients are not absorbed normally due to rerouting of the intestines. Needs lifelong multivitamin
Better control of diabetes than sleeve gastrectomy.
|Nutritional supplementation is important as fewer calories are consumed each day. Not recommended in patients with GERD (“acid reflux”).
Lower morbidity and mortality than bypass.