Gastric Sleeve Vs LAP-BAND® - All You Need to Know

The most important takeaways when evaluating gastric sleeve vs LAP-BAND® include:

  • How they work: Both make you feel full sooner while eating. Only sleeve makes you feel less hungry. Only LAP-BAND® (i) requires initial and ongoing adjustment by your surgeon and (ii) is reversible.
  • Qualify: Same requirements (30+ BMI with health problems, 40+ without)
  • Hospital & recovery: LAP-BAND® is a less complicated procedure with a shorter operating time and shorter hospital stay. In-hospital and post-op recovery is similar.
  • Weight loss & health improvement: Similar over long-term, but sleeve results in faster weight loss
  • Insurance: Same (if your policy covers bariatric surgery, both sleeve and band will be covered)
  • Cost: Same with insurance, bypass is about 25% more expensive without insurance.
  • Diet & life after: Similar diet and exercise regimen.
  • Complications & side effects: Both have a 99.8+% survival rate. Sleeve has a higher risk of short-term complications. Band has a higher risk of long-term complications.
Gastric Sleeve Vs Lap-Band

Read and click the sections below for everything you need to know to decide which procedure is best for you.

Also Read: To recover after the surgery is a big deal, so here you can learn laparoscopic sleeve gastrectomy recovery time and information about the processes that recovery time include.
Gastric Sleeve vs Lap Band

Understanding gastric sleeve surgery vs LAP-BAND® surgery starts with the fundamental differences in how each procedure impacts your digestive system:

Gastric Sleeve

Gastric Sleeve

Why Gastric Sleeve Works

  • Reduced stomach size makes the patient feel full sooner after eating
  • Removed portion of the stomach means fewer hunger-causing hormones are secreted, causing patient to feel less hungry generally

How Gastric Sleeve Is Performed

Gastric sleeve surgery, also called the Vertical Sleeve Gastrectomy (VSG), is performed by removing a large portion of the stomach to create a long pouch that connects the esophagus to the small intestine. The pouch is stapled and the rest of the stomach is removed. Some surgeons take an additional step to reinforce the staple line, although whether that is effective is up for debate.

LAP-BAND®

Lap-Band

Why LAP-BAND® Surgery Works

  • A band wraps around and squeezes a narrow section in the upper-middle part of the stomach. This creates a smaller stomach “section” above the band which fills up quicker after eating, causing the patient to feel full sooner and eat less.

How LAP-BAND® Surgery Is Performed

The LAP-BAND®, also called the gastric band or laparoscopic adjustable gastric band, has been used in Europe since the 90’s but wasn’t approved by the FDA in the States until 2001.

The gastric band surgery procedure involves the sewing of a silicone and Silastic band around the top of the stomach. A balloon around the inner surface of the band (imagine the inside of a bicycle tire) is connected to a tube that leads to a half-dollar-sized port above the abdominal muscles but below the skin.

During follow up visits, your doctor will add or remove saline solution (salt water) to make it tighter or looser. The tighter it is, the less hungry you feel and vice-versa.

The procedure is also fully reversible (unlike gastric sleeve).

Gastric Sleeve vs Lap Band

Patients lose weight quickly after both gastric sleeve and LAP-BAND®. However, gastric sleeve patients:

  • Tend to lose weight faster
  • Tend to reach a lower “low weight” than band patients
  • Tend to gain back more weight over the long-term (bringing sleeve weight loss back in-line with LAP-BAND® weight loss by year 5)

The below chart compares average weight loss over time for each procedure:

Timeframe
Timeframe
3 months
3 months
6 months
6 months
1 Year
1 Year
2 Years
2 Years
3 Years
3 Years
5 Years
5 Years
Timeframe
% of Excess Weight You’ll Lose with Gastric Sleeve
3 months
30%
6 months
50%
1 Year
70%
2 Years
65%
3 Years
60%
5 Years
55%
Timeframe
% of Excess Weight You’ll Lose with LAP-BAND®
3 months
20%
6 months
30%
1 Year
40%
2 Years
55%
3 Years
55%
5 Years
55%

Example

For for a person who is 5 feet, 7 inches tall and 250 lbs, following is the amount of average expected weight loss for each procedure:

Timeframe
Timeframe
3 months
3 months
6 months
6 months
1 Year
1 Year
2 Years
2 Years
3 Years
3 Years
5 Years
5 Years
Timeframe
Gastric Sleeve: Total Expected Weight Loss for 5’7”, 250 lb patient
3 months
28 lbs
6 months
46 lbs
1 Year
64 lbs
2 Years
60 lbs
3 Years
55 lbs
5 Years
51 lbs
Timeframe
LAP-BAND®: Total Expected Weight Loss for 5’7”, 250 lb patient
3 months
18 lbs
6 months
28 lbs
1 Year
37 lbs
2 Years
51 lbs
3 Years
51 lbs
5 Years
51 lbs
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Gastric Sleeve vs Lap Band

Studies evaluating gastric sleeve vs LAP-BAND® surgery have found very similar health improvement for diabetes, hypertension, sleep apnea, and most other obesity-related health problems, depending on which study is referenced.

The chart below compares study results by condition for each procedure:

Co-morbidity
Co-morbidity
Dyslipidemia hyperchole­sterolemia
Dyslipidemia hyperchole­sterolemia
Diabetes
Diabetes
Hyperli­pidemia (high levels of fat in the blood, high cholesterol)
Hyperli­pidemia (high levels of fat in the blood, high cholesterol)
High Blood Pressure (hyper­tension)
High Blood Pressure (hyper­tension)
Joint/Bone Disease (osteoar­thropathy)
Joint/Bone Disease (osteoar­thropathy)
Depression
Depression
Migraines
Migraines
Pseudo­tumor cerebri
Pseudo­tumor cerebri
Cardiova­scular Disease
Cardiova­scular Disease
Venous Stasis Disease
Venous Stasis Disease
Gastroeso­phageal Reflux Disease (GERD)
Gastroeso­phageal Reflux Disease (GERD)
Non-Alcoholic Fatty Liver Disease
Non-Alcoholic Fatty Liver Disease
Mortality Reduction/ Life Expectancy (5 year mortality)
Mortality Reduction/ Life Expectancy (5 year mortality)
Quality of Life Improve­ments
Quality of Life Improve­ments
Metabolic Syndrome
Metabolic Syndrome
Polycystic Ovarian Syndrome
Polycystic Ovarian Syndrome
Pregnancy
Pregnancy
Asthma
Asthma
Obstructive Sleep Apnea
Obstructive Sleep Apnea
Stress Urinary Inconti­nence
Stress Urinary Incontinence
Co-morbidity
Gastric Sleeve % Improved /Resolved
Dyslipidemia hypercholesterolemia
64%
Diabetes
55%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
35%
High Blood Pressure (hypertension)
68%
Joint/Bone Disease (osteoarthropathy)
46%
Depression
Most
Migraines
40%
Pseudotumor cerebri
n/a
Cardiovascular Disease
100%
Venous Stasis Disease
95%
Gastroesophageal Reflux Disease (GERD)
50%
Non-Alcoholic Fatty Liver Disease
n/a
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
93%
Metabolic Syndrome
62%
Polycystic Ovarian Syndrome
Most
Pregnancy
Most
Asthma
90%
Obstructive Sleep Apnea
62%
Stress Urinary Incontinence
90%
Co-morbidity
Band % Improved /Resolved
Dyslipidemia hypercholesterolemia
70%
Diabetes
60%
Hyperlipidemia (high levels of fat in the blood, high cholesterol)
23%
High Blood Pressure (hypertension)
43%
Joint/Bone Disease (osteoarthropathy)
81%
Depression
57%
Migraines
Some
Pseudotumor cerebri
Most
Cardiovascular Disease
73%
Venous Stasis Disease
Gastroesophageal Reflux Disease (GERD)
87%
Non-Alcoholic Fatty Liver Disease
Most
Mortality Reduction/Life Expectancy (5 year mortality)
89%
Quality of Life Improvements
Most
Metabolic Syndrome
78%
Polycystic Ovarian Syndrome
48%
Pregnancy
Most
Asthma
82%
Obstructive Sleep Apnea
85%
Stress Urinary Incontinence
82%

These surgeries can improve joint health. For every pound of weight lost, there is a 4 pound reduction in pressure on the knee joint (9). This improves mobility and reduces pain in the knees.

Both surgeries were part of research on cancer that included over 88,000 participants. Patients who undergo weight loss surgery have 33% less risk of developing cancer (10).

Risk rates were even further reduced for obesity-related cancers, including (11):

  • Colon cancer
  • Postmenopausal breast cancer
  • Endometrial cancer
  • Pancreatic cancer
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In order to have LAP-BAND® surgery or gastric sleeve surgery, your body mass index (BMI) must fall within one of the following ranges:

  • Body mass index 40 or above or
  • Body mass index from 35 to 40 as long as you have a serious obesity-related health problem (“comorbidity”) such as diabetes, asthma, hypertension, joint problems, sleep apnea, or one of many others.
  • Body mass index from 30 to 35 may be accepted if certain health issues are present

Use the BMI Calculator above to determine your body mass index.