Gastric Sleeve or Gastric Bypass: What’s the Difference?

Two commonly preformed weight-loss surgery procedures are the Roux-en-Y gastric bypass and the sleeve gastrectomy. Gary Korus, MD, FACS, bariatric surgeon at Penn Medicine, discusses the differences between these procedures.

Roux-en – Y Gastric Bypass

This laparoscopic procedure restricts food intake and shortens the digestive track by creating a small gastric pouch from the upper portion of the stomach. The intestine is surgically connected to this pouch, creating a small opening for food to pass through. The remaining larger portion of the stomach and part of the intestines are bypassed. The Roux-en-Y gastric bypass procedure limits the amount of food consumed and reduces the calories and nutrients absorbed from food.“The gastric bypass had been around for more than 25 years. Most people keep most of their weight off long-term,” says Dr. Korus. “It is also the only procedure that gives you feedback if you eat things you shouldn’t such as concentrated sweets.”

Sleeve Gastrectomy

During a sleeve gastrectomy, a sleeve-shaped tube is created from a small portion of the stomach and the majority of the stomach is removed. Food passes through the new stomach tube directly into the intestines. Nutrients and calories are absorbed from food normally, but patients feel full sooner and longer. Sleeve gastrectomy is performed laparoscopically and can be a permanent surgical solution to manage weight. Dr. Korus notes, “The gastric sleeve or sleeve gastrectomy provides an alternative for the patient that restricts what they eat without altering the route the food or beverages takes through the G.I. tract.”

Which Procedure is Better for Me?

How do you know which option is best for you? “The decision about what procedure is best for you can be made with your surgeon,” says Dr Korus. “Factors including your medical condition, medications, previous surgeries and dieting history will play a role in this decision.”

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Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

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The Unexpected Benefits of Being Fit

Bruce Sachais, MD, PhD, is an associate professor of pathology and laboratory medicine at Penn Medicine. In December 2010, he attended an informational session and decided to have weight-loss surgery. His Roux-en-Y gastric bypass surgery was performed at Penn by Noel Williams, MD. In this article, he discusses his struggle with weight, and why even as a physician, losing weight alone has been challenging. 

Read more about how Bruce lost 121 pounds. 

Nineteen months ago, I underwent gastric bypass surgery at Penn, a place that I know and love since I have worked there for the past 16 years. The most common question I get, after people realize that it is me (at least for those that have not seen me in a while) is how it feels and has it changed my life? Well of course it has, and for the better!

But, how does losing over a third of your body weight after being obese for most of your life change your life?

In so many ways.

First and foremost, I can again wear my wedding band; something I had not been able to do for over a year. What a wonderful feeling!

I have much more energy than I can remember ever having as an adult - energy for everything I do. I even appear more animated and enthusiastic when speaking with people, which had apparently been lost due to shortness of breath over the years. What an unexpected benefit.

Air travel is less uncomfortable as I can fit in the seat. So is going to the theater, as most theater seats (at least for live theater) are quite small.

My health is much better. All of my medical issues are either resolved or much improved. I guess the one exception to this is that my family still thinks I am crazy, perhaps even more so given my increased energy these days.

I don’t have to worry about walking around. In fact, I look forward to it. Before my surgery I would have problems after about 5 minutes, but now I can walk for over an hour. I can even run a little and have started a running program. My friends are shocked as I was never athletic at all. I even played in a charity softball tournament with my wife and younger daughter, who are real softball players. I can’t say I did well, but I did play and contributed to the team’s effort, - and had fun.

While these may not seem like major accomplishments for people that have been able to maintain a healthy weight and lifestyle most of their lives, they are significant to me. I feel that I have my life back.

Get Your Life Back

Whether it's playing with your kids, managing health conditions, or getting back to feeling like you, get Penn help you meet your weight-loss goals.

Join us for a free information session about weight-loss surgery at Penn. There, you'll be able to meet with Penn weight-loss physicians, and learn about your options in weight-loss surgery.

Join us for a free information session today.

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When Will Power and Knowledge Aren’t Enough

Bruce Sachais, MD, PhD, is an associate professor of pathology and laboratory medicine at Penn Medicine. In December 2010, he attended an informational session and decided to have weight-loss surgery. His Roux-en-Y gastric bypass surgery was performed at Penn by Noel Williams, MD. In this article, he discusses his struggle with weight, and why even as a physician, losing weight alone has been challenging. 

Read more about how Bruce lost 121 pounds.

As a physician, I should know better. I understand the importance of healthy eating and maintaining a healthy body weight. I understand biochemistry; how the molecules in the food we eat are extracted and used for energy, building up our bodies, and how they are stored (mostly as fat) when we consume more calories than we burn. I understand the importance of regular exercise, not only for burning calories, but for keeping many of our body tissues, such as our blood vessels, is a healthy state (which helps decrease the risk of heart attacks and strokes). So if it were just a matter of knowing, I should have been thin and healthy, but I was not.

To become an academic physician, one who both cares for people and performs research to improve the ability of medicine to care for people better, I am used to doing things that are difficult. Many years of education and training, long hours in the hospital, fighting for funding to support my scientific ideas all take time, dedication and determination. So if it were just a matter of willpower, of trying harder, I should be thin and healthy.

The fact is, for some people, it is more than that. Knowing what to do and having the determination to do it is just not enough for everyone to lose meaningful amounts of weight over the long haul. It was not for me. That is NOT an excuse by any means, and I want to stress that both knowing and determination are required (even after weight-loss surgery) they were just not sufficient. It was when I finally came to terms with this, that I took a serious look at surgery as a means to finally achieve my weight loss and health goals.

Through the education and information provided by the doctors, nurses and dieticians at Penn Metabolic and Bariatric Surgery Program, I learned about what gastric bypass could offer me, and what it could not. As a physician myself, I read some of the primary scientific literature, which supported all I had learned from the program. I learned how gastric bypass (as well as other surgical options) was most likely the tool I needed to allow me the success I needed, and deserved, to become a healthier and significantly smaller man. I learned that after surgery, both the anatomy of my digestive track (stomach and intestines) and biochemistry (chemical reactions and signals in the body) that control digestion and hunger would change. It is a combination of these changes, with my knowledge of healthy eating and exercise habits, and my determination (will-power) that have given me my success (down 121 pounds from a high of 322 pounds) to date.

I have chosen to write this because I want others to know that it’s okay to ask for help; that knowing what to do does not always allow a person to be successful in life, and that weight loss surgery, at least for me, has been the additional piece of the puzzle to allow me to meet my weight loss and health goals.

My life has changed for the better in so many ways, but that is a story for another day.

Are you ready to change your life with weight-loss surgery?

Let Penn Medicine help you lose weight, and get back to a healthier you.

Join us for a free information session about weight-loss surgery at Penn. Meet weight-loss surgeons, and find out about your options in weight-loss surgery.

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Physician Loses 100+ Pounds, Gains Life

Bruce Sachais, MD, PhD, is an associate professor of pathology and laboratory medicine at Penn Medicine. In December 2010, he attended an informational session and decided to have weight-loss surgery. Last March, at the age of 44, his Roux-en-Y gastric bypass surgery was performed at Penn by Noel Williams, MD.

Here, he talks about why he chose to have weight loss surgery at Penn, and how the Penn Metabolic and Bariatric Surgery Program team helped him lose 108 pounds.

I have struggled with weight ever since I was a toddler. As a child, I was never particularly athletic and every year I put on more and more weight. I tried everything under the sun to lose weight, but would often gain it right back – plus some.

I began to suffer from a variety of weight-related health problems. I had high blood pressure, severe gastric reflux disease, high cholesterol and sleep apnea.

As my weight increased, my activity level steadily decreased. I couldn’t walk more than a few minutes without resting. I avoided stairs at all costs, and frequently had to stop walking due to back pain.

I couldn’t even wear my wedding band as my fingers were too big for the ring.

The weight was winning, but I was not ready to stop fighting.

Taking Control

Realizing the increasing impact my weight problems were having on my life, I decided to explore surgical options and attend one of the free, educational sessions at Penn Medicine.

The education provided at this information session, along with my own research, led me to conclude that bariatric surgery at Penn was my best option for a happier, healthier future.

In March 2011, I underwent Roux-en-Y gastric bypass surgery and my experience with the Penn Metabolic and Bariatric Surgery Program team has been wonderful.

My team members have always treated me as person — with respect, compassion and professionalism. They are very responsive to my concerns, issues and needs. Their approach to weight loss and weight control goes far beyond surgery: it encompasses nutritional and behavioral aspects of weight loss as well, which is critical for long-term success in weight control.

Life After Weight-loss Surgery

Since my surgery I’ve lost 115 pounds, and I am still losing.

Today, I am able to walk without difficulty and for long periods of time. I now opt for the stairs, and I can even jog.

I feel like I am back to my normal self, because my weight doesn’t affect my energy levels and sleep. My blood pressure is back to normal, my cholesterol is much improved, and my sleep apnea has improved as well. My reflux disease is gone and I can wear my wedding band again.

My energy level is so much better than before the surgery. I don’t become short of breath nor do I feel aching in my back anymore. As a result of the surgery, everything I do throughout the day is better; more fulfilling. I have more energy for everything that I do.

I actually enjoy food more now, since I eat more slowly and taste all the wonderful flavors.

For the first time in my life, I truly control food…it does not control me.

That is a wonderful feeling.

Advice for Others

I encourage anyone thinking about weight-loss surgery to take the first step and attend an information session at Penn Medicine. For me, learning about my options and the program at Penn was an eye-opening experience. I learned the benefits, potential risks and what I would need to do to be successful and healthy after surgery.

And think about what you want for yourself: define your own health and weight loss goals.

Attend a support group at Penn Medicine. These meetings allow you to hear from and ask questions of a variety of people that have had one of these surgeries. It also allows you more opportunities to speak with members of the bariatric team.

It is important to understand that surgery is not the easy way out or a choice for someone who is weak. On the contrary, it takes commitment and work to be successful after surgery, but it is possible and my experience is a testament to that.

Get more information about weight loss surgery at Penn

Learn if bariatric surgery is right for you and attend a free information session about the Penn Metabolic and Bariatric Surgery Program.

At this free session, you will learn more about weight-loss surgery at Penn, and meet physicians and team members from the Penn Metabolic & Bariatric Surgery Program.

Register for this free event here.

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