WEIGHT LOSS

Almost all surgeons agree that there is greater weight loss for most patients after bypass compared to adjustable gastric banding. Everyone also agrees that weight loss occurs faster after gastric bypass.  In my own practice, our patients have lost an average of 75% of their excess body weight at 2 years after Laparoscopic Gastric Bypass surgery. After LapBand, patients lose an average of 50% of their excess body weight at 4 years after surgery.

EBWL = excess body weight loss

Our Lap Gastric Bypass patients have an average of 75% EBWL at 2 years after surgery

RISKS and COMPLICATIONS

Risks of complications are low after both procedures. Some of the complications like pulmonary embolus are common to both procedures. Some complications are fairly specific to gastric bypass, like intestinal leak or narrowing at the connection between the pouch and small intestine. Some complications are specific to Laparoscopic Adjustable Gastric Band surgery such as gastric edema, band slippage on the stomach or band erosion. Complications after gastric bypass like intestinal leak are often more serious with a slower recovery than complications such as band slippage or gastric edema following banding.

The risk of dying from complications of either surgery is low. Both surgeries are less dangerous than many commonly performed surgeries such as colon and rectal resections. National statistics have reported the risk of dying after gastric bypass done either open or laparoscopically at 1 in 200, and the risk of dying after LapBand surgery at 1 in 1000. Taking into account the differences in study populations, Laparoscopic Adjustable Gastric Band surgery is roughly twice as safe as Laparoscopic Gastric Bypass.

RECOVERY

Both operations can be done laparoscopically by a skilled surgeon. Both offer a fast return to normal activity for most patients. However, return to normal activity is generally easier after Laparoscopic Adjustable Band surgery.

FOOD INTOLERANCE

Patients may or may not have food intolerances after either operation. Generally, food intolerances after gastric bypass are related to high sugar or fat content while food intolerances after Laparoscopic Gastric Banding are generally related to problems based on size and consistency.

Eating or drinking foods with a high sugar or fat content after Laparoscopic Gastric Bypass can cause abdominal cramping, flushing, and occasionally the need to go to the bathroom; this is called  the "dumping" syndrome.

VITAMIN AND MINERAL DEFICIENCIES

Both procedures carry very low risk of vitamin and mineral deficiencies. After Laparoscopic Gastric Band surgery, all patients should take a daily multivitamin and should consider taking calcium and iron to supplement the daily diet. If you are on acid reducing medicines like Nexium, you should also consider taking B-12 supplements.  After laparoscopic gastric bypass surgery, all patients should take a daily multivitamin and should consider taking B-12, calcium and iron to supplement your daily diet.

REVERSIBILITY

Both operations can be "reversed" or to be more exact can be "undone", although after reversal patients regain all their weight. Laparoscopic Adjustable Gastric Band removal is much simpler and easier to perform and recover from than reversal of a gastric bypass, even when the gastric bypass reversal is done laparoscopically.  

DIABETES

Laparoscopic Gastric Bypass results in immediate and more dramatic improvement in diabetes. This is related to the food bypassing the duodenum. Laparoscopic Adjustable Gastric Banding results in improvement in diabetes as you lose weight.

PREGNANCY

Pregnancy is equally safe after either operation. You can become pregnant after Laparoscopic Gastric Bypass or after Laparoscopic Gastric Banding.

OTHER ISSUES

Some patients choose the Laparoscopic Adjustable Band because it is adjustable for travel or vacation while others prefer Laparoscopic Gastric Bypass because they dislike the idea of having a port under the skin and needing to have fills and adjustments. On average, patients have 3 to 4 adjustments per year for a variety of reasons after Laparoscopic Adjustable Band surgery.