Lap-band surgery and gastric sleeve surgery are two different types of weight loss surgery, also known as bariatric surgery. They are options for treating obesity to help avoid additional health complications. Both procedures involve surgically adjusting the size of the stomach so that it holds less food. Both procedures do so in different ways and target slightly different patients.
This article provides an overview of lap-band surgery and gastric sleeve surgery, outlining what you should know about these weight loss procedures and their results.
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What to Know About Lap-Band Surgery
Laparoscopic adjustable gastric band surgery—or lap-band surgery for short—is one option for weight loss surgery that involves placing a silicone band around the upper part of the stomach to reduce its size.
How Does It Work?
As with other bariatric procedures, the goals of lap-band surgery are to increase weight loss and improve any health complications related to obesity. This includes medical conditions such as high blood pressure, sleep apnea, and type 2 diabetes.
Experts recommend the following criteria in order to be a candidate for lap band surgery:
- A body mass index (BMI) of 30–40
- At least one other obesity-related medical condition, like type 2 diabetes
Surgically wrapping a band around the top portion of the stomach limits the amount of food that will fit into the stomach. Ideally, this will make you feel full after eating smaller amounts of food than usual.
BMI is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.
Lap-Band Surgery Delivery
Lap-band surgery is performed by a bariatric surgeon in a hospital under general anesthesia. It's most often done laparoscopically, which means the surgeon inserts small tools into small incisions made in the abdomen. In rare cases, lap-band surgery may be performed as an open surgery, which involves a much larger incision in the abdomen.
This procedure is typically done on an outpatient basis, which means it doesn't require an overnight hospital stay. And unlike other options, lap-band surgery is reversible. The band that's used to wrap around part of the stomach can be adjusted or removed by the surgeon. It doesn't involve any cutting of the actual stomach organ.
Side Effects
While lap-band surgery is minimally invasive, there are potential side effects that you may experience following the procedure. Some of the most common are:
- Diarrhea
- Bleeding
- Infection
- Nausea and vomiting
- Decreased appetite
- Vitamin deficiency
- Blood clots in the legs
- Gallstones
- Movement of the gastric band out of proper position
Prices & Where to Get It
The cost of lap-band surgery can vary depending on several factors, such as location, hospital system, and whether it's covered by your health insurance plan (if you have access to insurance).
Experts estimate that bariatric surgery in general can cost between $15,000 and $25,000, or more. One older study estimated the mean cost is about $20,000.
What to Know About Gastric Sleeve Surgery
Gastric sleeve surgery—also known as sleeve gastrectomy—is a common option for bariatric (weight loss) surgery. It involves removing a portion of your stomach, limiting the amount of food you can eat, and making you feel fuller faster.
How Does It Work?
Gastric sleeve surgery helps with weight loss by physically reducing the size of the stomach. Up to 80% of the stomach is removed during this procedure, resulting in a much smaller stomach organ that's shaped like a sleeve or a banana.
The goal is twofold: to improve weight loss and to treat obesity-related health conditions, such as high blood pressure or type 2 diabetes. According to the American Society for Metabolic and Bariatric Surgery, gastric sleeve surgery is the most commonly performed bariatric procedure in the United States.
To be a candidate for gastric sleeve surgery, experts recommend the following guidelines:
- A body mass index (BMI) of 40 or higher
- A BMI of 35 or higher in addition to another obesity-related medical condition, like type 2 diabetes
- Having undergone other weight loss methods, such as diet, lifestyle or behavioral modifications, and medication, that haven't been successful
Gastric Sleeve Surgery Delivery
Gastric sleeve surgery is performed by a bariatric surgeon in a hospital or surgical center with general anesthesia. It’s usually done laparoscopically, using minimally invasive techniques, but it can also be performed as open surgery with a large incision.
The large portion of the stomach is typically sealed and divided with surgical staples. The large portion that is separated is subsequently removed from the body.
In addition to making the stomach smaller, gastric sleeve surgery also removes parts of the stomach cells that produce ghrelin, the hunger hormone that signals you're hungry. This helps decrease your appetite and often contributes to better weight loss results.
Side Effects
When compared to gastric bypass surgery (another weight loss procedure), gastric sleeve surgery is generally considered to be less risky and easier to perform.
Still, it’s not uncommon to experience certain side effects following gastric sleeve surgery. These include:
- Gastritis (stomach lining inflammation), heartburn, or stomach ulcers
- Vomiting
- Leaking from the surgical site on stomach
- Vitamin deficiency
- Internal scarring
- Injury to internal organs
- Gallstones
Prices & Where to Get It
Similar to lap-band surgery, gastric sleeve surgery pricing will depend on factors like whether you have health insurance and where you're getting the procedure done. Many health insurance plans cover weight loss surgery that they consider to be medically necessary.
The American Society for Metabolic and Bariatric Surgery notes that the average cost of bariatric surgery ranges from $17,000 to $26,000.
Which Treatment Is Best for You?
Both lap-band surgery and gastric sleeve surgery have the same end goal: to help people whose health may be at risk from obesity lose excess weight and live a healthier life.
Still, there are a few differences to consider in thinking about which procedure to pursue, including:
- BMI: The BMI requirements for gastric sleeve are slightly higher than lap-band requirements.
- Permanence: Lap-band surgery is reversible, while gastric sleeve is not.
- Effectiveness: Weight loss and disease improvement rates are higher in the gastric sleeve than in the lap-band.
- Weight loss approach: Gastric sleeve actually decreases hunger and helps control blood sugar, while lap-band surgery does not.
- Complications: Lap-band has the lowest risks of surgery complications and vitamin deficiencies.
- Long-term care: Lap-band surgery may require several band adjustments, and it's possible for the band to move out of place or damage the stomach over time.
- Other issues: Gastric sleeve can worsen or cause acid reflux and heartburn, while lap-band can cause swallowing problems and an enlargement of the esophagus (the tube that connects the throat to the stomach).
Your healthcare provider will be able to discuss these risks and benefits and provide the weight loss surgery options that will be most effective for your individual situation.
Can Lap-Band and Gastric Sleeve Surgery Be Used Together?
Lap-band and gastric sleeve surgery are not used together at the same time. But it is possible to have lap-band surgery first—and then get gastric sleeve surgery later on.
For example, people who aren't satisfied with lap-band surgery results may be candidates for trying another bariatric surgery. In these cases, the surgeon can remove the lap-band and perform a gastric sleeve operation either immediately after or at a later date.
Coping With the Side Effects
While each person will react to and recover from weight loss procedures differently, your bariatric surgeon or healthcare provider may recommend some of the following treatments to help with side effects:
- Gradual increase of food and drink intake to ease abdominal pain and related issues
- Prescription or over-the-counter (OTC) medications for nausea, diarrhea, or vomiting
- Vitamins and supplements to treat nutritional deficiencies
- Light exercise routine to ease fatigue and promote healthy lifestyle habits
- Prescription medication to reduce the risk of gallstones
- Incision cleaning and care to prevent infections
- Prescription medication to prevent blood clots
For more serious risks such as leaking from the stitches, scarring, or an injury to the internal organs, your surgeon will discuss the warning signs so you'll know exactly what to do and when to seek medical attention.
Summary
Lap-band surgery and gastric sleeve surgery are two commonly used procedures to treat obesity and related health conditions. They work by reducing the stomach size and limiting the amount of food that can be consumed. While lap-band surgery is reversible, gastric sleeve surgery is not. A healthcare provider will be able to help determine whether you're a candidate for either weight loss procedure.
A Word From Verywell
There are several different types of weight loss procedures and no one-size-fits-all approach. While lap-band surgery may work well for one person, gastric sleeve surgery may be more effective for someone else. For the best overall results, keep in mind that any bariatric surgery will require a commitment to a healthy diet, regular exercise, and lifestyle modifications.