Expert: John Pilcher, MD - 1/27/2010

Question
I am considering bariatric surgery. I am concerned that the Gastric Sleeve invoves removal of 85% of the stomach and is obviously irreversible. Am I right though in saying tt is not unstoppable you could say as the remaining stomach can expand if too much is eaten?
In light of this is it not better to go for the full By-pass which leaves only a small pouch even though it requires the bowel to do the micro-absorbsion of vitamines?  

Answer
Paul,
You are understanding correctly that the gastric sleeve involves removal of some 85+% of the stomach.  As such, it is truly non-reversible.  Surgeons like myself who perform the gastric sleeve are reassured by the fact that decades of experience with gastric resection done for other reasons (ulcer, cancer, etc) have not revealed any health problems from removal of that section of stomach.

On the other hand, the gastric bypass is clearly the procedure with the longest and best track record in the field of bariatric surgery.  If you are seeking the most reliable option for your weight control and improved health, the gastric bypass is probably the leading choice.

Best of luck!
Dr JP