Lap band versus gastric sleeve – which is better?

Just as my question states, when comparing lap band versus gastric sleeve surgery, which is better? I am 70 lbs overweight and know that I need to make a drastic change in my life. I know that gastric sleeve surgery is irreversible, so that scares me a little, but if it’s much better than lap band I want to know.


M, 40, Oregon

Tags:man age 35-44 overweight

Making the decision to undergo bariatric surgery can be daunting, but the postoperative benefits you will enjoy are significant. It’s excellent that you’re researching and educating yourself on the differences between these procedures. Understanding what sleeve gastrectomy surgery and lap band surgery entail will help you determine which procedure is the more suitable option for you. It can also help to demystify the operation and make it seem less overwhelming.

Sleeve gastrectomy, or gastric sleeve surgery, is a non-reversible procedure. It requires the removal of a large portion of the stomach, including the part that contains the hormone responsible for producing hunger, ghrelin. The remaining portion of stomach takes on the shape of a tube or a sleeve.


This procedure requires a longer recovery time than lap band surgery, as the internal sutures take several weeks to heal before you can return to eating solid food. However, one of the distinctive benefits of this procedure over lap band weight loss surgery is that patients generally enjoy superior weight loss during the first 12-18 months. Studies show that steady weight loss during these crucial months is vital to boosting morale and encouraging the development of good eating habits. Psychologically, this can be an advantage.

Lap band surgery involves the insertion of a device that modifies the stomach so it holds less food. It essentially cinches the stomach, creating a small pouch that holds a mere fraction of the food the stomach usually contains. This band is inflated or deflated with saline injections through a small port that lies beneath the skin. There is no invasive cutting or stapling in lap band surgery, and the band is adjustable and reversible.


However, lap band patients do sometimes experience some side effects such as intolerance of the band, leaking, or infections around the skin port. Lap band surgery has a shorter recovery period than sleeve gastrectomy, but it does require ongoing maintenance. What's more, the part of the stomach that produces hunger remains unaffected as a result of lap band surgery. These days, lap band surgery is not commonly performed, with surgeons more likely to carry out gastric bypass surgery, roux-en Y, and sleeve gastrectomy instead.

In short, both surgeries assist obese patients to lose weight and improve their health and quality of life, but sleeve gastrectomy is more common. Schedule a consultation with a board-certified surgeon: many esteemed surgeons hold accreditation gained through the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Surgeons with this accreditation are subject to rigorous evaluations, safety training and surgical volume standards to help promote excellence. Your surgeon will help determine the most suitable procedure for you.

Bariatric procedures such as lap band surgery and sleeve gastrectomy represent effective options for long-term weight loss. Patients with a BMI of at least 30, and up to 40, can benefit from either of these weight-loss procedures. While both are performed laparoscopically (through keyhole surgery) and share the objective of helping obese patients safely and successfully lose weight, they do differ quite substantially in their effects on your digestive system.

Understanding the difference between the two procedures will help inform your decision about which surgery will benefit you most. Your surgeon is also a valuable source of information and will help you determine which procedure may be the most suitable to ensure you gain the best outcome. They will also educate you on the risks and complications associated with each procedure.

Lap band surgery was once the most popular weight loss surgery in the United States. Nowadays, bariatric surgeons perform the procedure less and less as the surgery has fallen out of favor and newer forms of weight loss surgery have become more common. Lap band surgery involves the application of an adjustable ring around the stomach, creating a small stomach pouch to limit food intake.

While lap band surgery boasts a relatively short recovery time (many patients undergo the surgery as a day stay or on an outpatient basis), unfortunately, it is accompanied by a higher rate of long-term complications. Lap band patients sometimes require revision surgical procedures to address device malfunction. Issues such as leaking, lap band erosion, displacement or slippage require surgical correction.

Sleeve gastrectomy has been clinically recognized as more effective in promoting weight loss than adjustable gastric banding. This is likely because the sleeve gastrectomy promotes more rapid loss in the first year following surgery, which can be motivating for patients. During the procedure, a portion of the stomach is removed, leaving only a small, sleeve-shaped pouch approximately the size of a banana, behind.

As such, patients are unable to consume as much food as they did before undergoing the procedure, while the hormone responsible for producing hunger located in the stomach is also removed, helping reduce hunger pangs. The procedure is irreversible but significantly less likely to require reoperation or ongoing maintenance than the lap band approach. Gastric sleeve patients do, however, have a longer recovery period and are at a slightly higher risk of short-term complications such as gastric leakage or dumping syndrome.