Comparison between Laparoscopic Gastric Banding, Gastric Bypass and Sleeve Gastrectomy:

Gastric Band

Gastric Bypass

Sleeve Gastrectomy

Effects

Variable restriction
Little change in appetite

Moderate restriction
Loss of appetite
Aversion to sweet foods (dumping syndrome)

Moderate restriction
Loss of appetite

Surgical technique

Keyhole surgery
4-5 small cuts

Keyhole surgery – 4-5 small cuts
Open surgery – 15-30 cm cut

Keyhole surgery
4-5 small cuts

Hospital stay

Day-case or 1 night

2-4 nights (keyhole or open)

2-3 nights

Recovery

1-2 weeks

2-3 weeks

2-3 weeks

Expected weight loss (average)

50% Excess weight

60-70% Excess weight

50-60% Excess weight

Surgical risks

Mortality: 1in 2000
Complications:
Early – 1 in 100
Late – 1 in 20

Mortality: 1 in 200
Complications: 1 in 20

Mortality: 1 in 500
Complications: 1 in 20

Long-term effects

Band adjustments necessary for weight loss;
Dietary and lifestyle changes necessary for success

Restriction decreases after 1 year to stabilise weight loss;
Appetite remains less;
Dumping may fade after 1 year, dietary control still necessary

Loss of restriction in 15% with weight regain;
Dietary and lifestyle changes necessary for success

Long-term problems

Band failure: 1 in 20
Flipped port: 1 in 50
Band slippage: 1 in 50
Band erosion: 1 in 50
Band removal: 1 in 10

Nutritional deficiency (Iron, Calcium, Vitamins);
Internal  hernia / adhesion  problems;
Incisional hernia (Open surgery)

Loss of restriction;
Return of appetite;
Further surgery to maintain weight loss

Dietary supplements

None

Multivitamin x1 daily
Iron + Calcium: if at risk

None