We are all hearing a lot more about the Gastric Sleeve.  The following information has been provided by Allergan, the manufacturer of the LAP-BAND® system.  It compares banding to gastric bypass and gastric sleeve.  First and foremost, it's important for you to discuss your options with your doctor to determine the best path for your weight loss journey. 

Comparing LAP-BAND® and Gastric Sleeve

 Below are illustrations of three bariatric procedures:  one is a band, two are stapling procedures. 

Below is a brief list of four common questions and answers about gastric sleeve provided by the manufacturer of the LAP-BAND ® system.

1.  Does gastric sleeve provide faster weight loss?

 While gastric sleeve may offer more rapid initial weight loss in the first 1 to 2 years, after about 3 years, total weight loss is comparable to weight loss with gastric banding.1

 The 2 year data from the APEX study show that excess weight loss with the LAP-BAND® AP System was 53%.6 That particular study has 508 patients from 44 different sites of care within it and 108 of those patients have reached their two year mark.

 The LAP-BAND® System was approved in the United States on the basis of a nonrandomized, single-arm study (N=299).  Significant improvement in percent of excess weight loss vs.  baseline was achieved at 12 months (34.5%), 24 months (37.8%), and 36 months (36.2%).

 2.  Does gastric sleeve provide guaranteed weight loss?

 As with any weight loss procedure, results for gastric sleeve and the LAP-BAND® System may vary. 

 Gastric sleeve results are expected to be similar to gastric bypass.  However, the laparoscopic sleeve gastrectomy procedure with a large sleeve volume has shown a slight weight gain during 5 years of observation.2 Typically, long-term weight loss results are comparable to gastric bypass.1

 An ongoing U.S.  study of 508 patients called APEX has shown significant reductions in weight using the LAP-BAND ® System.  Those treated with the LAP-BAND® lost 47% of their excess weight in the first year (N=139 patients at 48 weeks).3, 4 And again, the 2 year data from that same study (N=108 patients) showed that the excess weight loss with the LAP-BAND® AP System was 53%.6

 The LAP-BAND® System was approved in the United States on the basis of a nonrandomized, single-arm study (N=299).  Significant improvement in percent of excess weight loss vs.  baseline was achieved at 12 months (34.5%), 24 months (37.8%), and 36 months (36.2%).

 3.  Is it true that the gastric sleeve procedure requires minimal follow-up?

 Since such a large part of the stomach is removed permanently during the procedure, there are not really any "adjustments" or follow-up to be made following the gastric sleeve surgery.  This also means that there is no standardized system for follow-up care and motivation of patients.  All bariatric surgical procedures need follow-up visits as well as a modified diet and exercise program to enhance success.  Without these and the patient's dedication to them, the procedures will likely fail. 

 Patients who undergo the LAP-BAND® procedures have short and simple adjustment visits with their physicians every 4-6 weeks during their first year of care.  Many physicians use these visits as an opportunity to track weight-loss progress and give patients encouragement.  Patients also have access to My LAP-BAND® Journey, an online patient support resource, which offers patients comprehensive pre- and post-operative tools for practical and emotional support.

 4.  Is the gastric sleeve less invasive than LAP-BAND?

 No.  Sleeve gastrectomy is a restrictive procedure that limits food intake by cutting and stapling a thin vertical section of the stomach to make a smaller, narrower stomach pouch.  The remaining larger portion of the stomach is then permanently removed.  Unlike gastric bypass, there is no re-routing of the intestines.  However, the sleeve gastrectomy involves permanently removing a large portion of the stomach. 

 The LAP-BAND® procedure is a restrictive procedure during which an adjustable gastric band is placed around the upper part of the stomach.  This creates a smaller stomach pouch, which restricts the amount of food that can be consumed at one time and helps the patient to feel full sooner.  The procedure, which is adjustable and reversible and designed for sustained weight loss, involves no cutting or stapling of the stomach or intestinal rerouting.  Most people will spend less than 24 hours in the hospital.  It takes most patients about a week to return to work and a month to six weeks to resume exercising. 

 Additionally per the most recent publication in JAMA, a study examined hospital bariatric surgery complication rates for more than 15, 000 patients in Michigan.  The study showed that overall the most serious complications were most common after gastric bypass (3.6 percent), followed by sleeve gastrectomy (2.2 percent) and gastric banding (0.9 percent).