By Katherine Habenicht Yancey, MD
Fellowship-Trained Bariatric Surgeon
Thinking about exploring bariatric surgery? These questions are among the most frequently asked by my patients:
Is the sleeve gastrectomy a “less invasive” operation than the gastric bypass?
No. The sleeve gastrectomy and Roux-en-y gastric bypass are the two most common weight-loss operations we perform at Mission Weight Management. They both require general anesthesia, are performed laparoscopically and recovery is similar for both surgeries. Usually the number of laparoscopic port sites is the same, and incisional pain is similar for both surgeries. The difference lies in surgical risk, not level of invasion. In both cases you are having gastrointestinal abdominal surgery; changes in your anatomy should be thought of as permanent.
What is my recovery time?
For either sleeve gastrectomy or gastric bypass, recovery is similar. I usually tell my patients to plan for at least one week off work (if you have a sedentary job), but this can be extended up to two months if necessary. Usually the pain from healing is not what keeps you from feeling up to working, but instead your ability to hydrate yourself the first days after surgery to avoid complications (i.e., dehydration, which can lead to nausea, vomiting, constipation, UTIs). Therefore, it is really up to how you feel after surgery and whether you think you are ready to return to work or your regular family duties. I will say on average, patients take about two weeks.
How much weight should I expect to lose?
Bariatric surgeons calculate your expected weight loss based on statistics from previous research studies. I like to do this math with my patients so we all have a realistic expectation of the weight-loss journey. First, you must define your “ideal body weight” (IBW). An easy way to do this is find what weight you would be at a BMI of 25. Now, subtract this number from your actual weight, and you will get your excess body weight (EBW). EBW is a percentage of this number that we expect you to lose with either sleeve gastrectomy or gastric bypass, or excess body weight loss calculation (EBWL). We predict a weight loss of 60-70 percent of EBW with sleeve, and 70-85 percent with bypass.
Calculations are not based on your ideal body weight. Our goal here is get you to a healthier weight, feeling good, able to exercise regularly and participate in activities that bring you joy.
Why did I specialize in bariatric surgery?
I hear this question most often from my bariatric patients. My answer is twofold:
First, I like performing bariatric surgery. I enjoy the actual operations. The gastric bypass is one of the most complex elective cases that we offer our patients. I wanted to own this operation and the skillset it requires, and provide it safely to my patients. Second, I truly enjoy taking this weight-loss journey with my patients. In general surgery, there are few areas that allow continuity of care. I am honored to actively participate in helping my patients become healthier individuals. Aside from operating, my favorite thing to do as a physician is take people OFF of their medications.