Detailed Comparison of Our Procedures

Laparoscopic Gastric Bypass Laparoscopic Sleeve Gastrectomy
Graphic Representation Gastric Bypass Image Sleeve Gastrectomy Image
How is it done? Small 30-40 ml gastric pouch is connected to the small intestine bypassing the stomach. Food and digestive juices are separated for 3-5 feet. Most of the stomach is removed in a “vertical” fashion leaving a “banana” shaped stomach remnant.
How does it work? Significantly restricts the volume of food that can be eaten. Mild malabsorption. “Dumping Syndrome” if wrong foods such as sugar or fats are eaten. It reduces production of the ghrelin hormone by the stomach thus reducing appetite. It restricts somewhat the volume of food that can be eaten. It also allows food to pass quickly down the gut. It removes the ghrelin hormone producing cells of the stomach. All these may reduce appetite.
What surgical approach is used for each surgery? Laparoscopic or minimally invasive with 5 small cuts. No adjustment port therefore avoids the larger 2 cm skin cut. Laparoscopic or minimally invasive with 5 small cuts are used. No adjustment port therefore avoids the larger 2 cm skin cut.
What weight loss can I expect with this surgery? ~70% of extra weight lost at 5+ years  ~60% of extra weight lost at 5+ years 
What diet and lifestyle changes are required of this surgery? Patients consume 3 small high protein meals and 2-3 high protein snacksMeal portions usually amount to ~ 1 cup per meal. Must delay fluids from solids. Advised to limit concentrated sugars to avoid dumping syndrome. Must exercise Patients consume 3 small high protein meals and 2-3 high protein snacks. Meal portions usually amount to ~ 1 cup per meal. Must delay fluids from solids. Advised to limit concentrated sugars. Must exercise. 
Which nutritional supplements am I required to take for life after surgery? Multivitamin 
Vitamin B12 
Calcium & Vitamin D  
Iron (menstruating women)  
Multivitamin 
Vitamin B12 
Calcium & Vitamin D  
Iron (menstruating women)  
What are the chances I might die from this surgery and are there any other immediate risks?
SHORT TERM (30 day)
Death* 0 %
Staple line leak 1 %
Internal bleeding 1 %
Colon perforation 0.1 %
Deep vein thrombosis 0.4 %
Liver/Spleen laceration 1.4 %
Port site infection 1.2 %
Heart attack 0.2 %
Pulmonary Embolus 0.2 %
* These are Dr. Chow and Dr. Christou’s statistics in private practice from 2006-2020 in over 1,500 cases
SHORT TERM (30 day)
Death* 0 %
Staple line leak 1%
Minor bleeding 1.5 %
Liver/Spleen laceration 1.4 %
Deep vein thrombosis 0.2 %
 Port Infection 2.0 %
 
What are the long term risks from this surgery?
LONG TERM
Severe Anemia 10 %
Stricture of the stomach outlet 4%
Stomach pouch ulcers 1.4 %
Port site hernia 0.8 %
Gallstones (10 years) 14.4 %
Small bowel obstruction 2.6 %
Kidney Stones 2 %
Vitamin/mineral deficiencies 2 %
LONG TERM
Anemia 5%
Stricture of the sleeve 2.0 %
Stomach ulcers 1.4 %
Port site hernia 0.8 %
Gallstones (10 years) 17.3 %
Small bowel obstruction 2.6%
Kidney stones 2%
Vitamin/mineral deficiencies 1%
How quickly will I lose the extra weight? Most of the weight loss occurs within the 1-2 years after surgery. Some weight regain and stabilization is dependent on patient compliance with diet and exercise.  Most of the weight loss occurs within the 1-2 years after surgery. Some weight regain and stabilization is dependent on patient compliance with diet and exercise. 
How long does the surgery take to perform? 75 min 60 min
How long will I be hospitalized for? 2 days (48 h) 1 day (24 h)
What is the period of convalescence? Because this is minimally invasive surgery patients only need to convalesce for 1 – 2 weeks at home (some patients can return to desk jobs within 1 week of surgery) Because this is minimally invasive surgery patients only need to convalesce for 1 – 2 weeks at home (some patients can return to desk jobs within 1 week of surgery)
How long do I wait for the surgery? 4-6 weeks, the time needed for proper preparation for safe surgery 4-6 weeks, the time needed for proper preparation for safe surgery
Who pays for the surgery? Patients must pay out of pocket, through financing, or their insurance. Patients must pay out of pocket, through financing, or their insurance.
Is the operation reversible? Possible, if medically indicated.   No.
Our Recommendation Strongly recommended for patients with type II diabetes, severe GERD (not controlled by medications), and people with a high BMI.     This has been performed for over 40 years and has proven long term durable results.    Most popular surgery in North America with excellent weight loss outcomes. 

Laparoscopic Roux-en-Y Gastric Bypass

The laparoscopic RY gastric bypass is performed by introducing a laparoscope, which is connected to a video camera, through small abdominal incisions, giving a magnified view of the internal organs on a television monitor. Learn more

Laparoscopic Vertical Sleeve Gastrectomy

Vertical sleeve gastrectomy, also known as parietal gastrectomy or just Sleeve gastrectomy consists of an operation that aims, if performed alone, to be restrictive in nature. Learn more