Sleeve gastrectomy, adjustable gastric band, gastric bypass, duodenal switch, or the gastric balloon; what operation is the best weight loss surgery?

I recently returned from a 2-day conference where some leading experts in the field of bariatric surgery discussed this very thing, and most agreed that it was a combination of the patient’s choice and the surgeon’s recommendation.  Certainly, there are medical and/or surgical reasons to insist on one operation over another, but most of the time, the surgeon will defer the type of operation to the patient’s choice.  Is this the right thing to do?  Does the surgeon have a medical obligation to recommend the sleeve gastrectomy over the adjustable gastric band, or vice versa?  Unfortunately, sometimes the decision is not an easy one.  There are many factors that go into a patient’s decision to have one operation over another, and many more factors for the surgeon to decide.  Medical co-morbidities (diabetes, hypertension, sleep apnea, gastroesophageal reflux disease), past surgical history, including previous weight loss surgery, and sometimes social history (Is the patient a smoker or does he/she drink alcohol?) can all factor in to what is the “best” operation to have.  Remember, these are elective operations, much like plastic surgery, and despite the severe medical problems we are trying to correct with the operations, they are not considered emergency surgeries like heart surgery or brain surgery might be. Regardless of the fact that they are not emergency surgeries, I do think we, as providers, have a duty to advise patients of what our medical opinion is based on all the factors we are aware of.  Most patients do not come for a consultation having read the last 10-20 research papers on weight loss surgery, but we as clinicians have a duty to keep up to date on the latest techniques and advances in our field of medicine, and we need to feel confident enough to share that with our patients who are trusting us to operate on them to lose weight.  This is a tremendous responsibility and we should give them nothing short of our best, at all times.

There is no trial period for your operation, so patient’s need to invest the time and effort to research the operations and come to their consultation with an understanding of how each operation works and how their particular choice can benefit them the most. Currently in our practice, the sleeve gastrectomy is by far the most popular. The recovery time is equal to the other operations, the weight loss is superb, the control of diabetes and other health issues is excellent and it is the most maintenance free after surgery.

If you are interested in weight loss surgery, including the sleeve gastrectomy, the gastric bypass, the gastric band, or the duoedenal switch, contact us today and we will discuss and find the best operation for your specific situation.