HELP ME CHOOSE

Here is a side-by-side comparison of each procedure to help you compare. We present the established (approved) procedures. We do not discuss experimental procedures such as gastric plication, intestinal interposition or controversial procedures such as the mini-gastric bypass.

Dr. Christou’s recommendations are shown at the end of the table.

Gastric
Bypass
Sleeve
Gastrectomy
PPDDS Gastric
Banding
Single or Dual
Gastric
Balloon
Graphic
Representation
Gastric Bypass Realize ENG VSG Realize ENG PPDDS_ENG_REALIZE Gastric band Realizr English Re-Shape Duo in place1
Popularity -
World wide
 52%  35%  2%  5%  No Data
How long do I
stay in hospital?
 2 days  1 day  2-3 days  <23 hours ~4 hours
How long before I
can return to
work?
 2 weeks  2 weeks  3 weeks  1 week 2 days
Is the surgery
reversible?
 YES  NO  NO  YES The balloon MUST
BE REMOVED
at 6 months
Does the procedure
eliminate hunger?
 YES YES YES  NO NO
Chance of dying
within 30 days
of surgery
 0 – 0.5%  0 – 0.5%  0 – 1.6%  0 – 0.3%  0
Average weight
loss after 5 – 10 years
 70% of excess
weight
 55% of excess
weight
 75% of excess
weight
 50% of excess
weight (in patients who still have their band)
 No data
How fast will I
reach my maximum
weight loss?
 18 months  2 years  18 months  2-3 years Balloon can
only stay in
for 6 months
Can I regain
weight after
this procedure?
 +  ++  + +++  All lost weight
can be regained
after balloon
is removed
Type-2 Diabetes
control
 +++  ++  ++++  +  No data
High Blood Pressure
control
 +++  ++  +++  +  No data
Lipid & Cholesterol
control
 +++  ++  ++++  +  No data
Sleep Apnea
control
 +++  ++  +++  +  No data
Reduction in
risk of dying 5
years after
the procedure
 34 – 89%  No data  No Data  38%  No Data
 Life-Long
complications
Anemia ++
Vitamin Deficiency ++
Kidney Stones +
Anemia ++
Vitamin Deficiency ++
Anemia +++
Vitamin
Deficiency +++
Kidney Stones ++
Low Albumin +
Frequent bowel
movements +++
Anemia +
Vitamin Deficiency +
 No Data
(some balloons especially the single type have burst, migrated into the gut and have caused severe complications and sometimes death)
 Dr. Christou’s Recommendations Reccomended  for patients with a BMI of >40 kg/m2.

It is considered the “Gold Standard Procedure” for weight loss in North America.

The majority of our patients chose this procedure.
Best for patients with
BMI=32-50 kg/m2(with at least one obesity associated disease like diabetes) who enjoy participating in an
exercise program and are more disciplined and can follow dietary restrictions.

Dr. Christou’s main reservation is the lack of long term weight loss results.

Time will tell!
Best for patients with BMI>60 kg/m2 who accept certain inconveniences like frequent bowel movements, flatulence etc.

Dr. Christou’s main reservation is the need for rigid adherence to diet supplements which most patients fail to follow long term.
WLS DOES NOT OFFER THIS SURGEY DUE TO HIGH COMPLICATION RATES AFTER % YEARS.Not recommended due to high rate of complications after 3-5 years.

Revisional surgery to sleeve or bypass can be difficult.

It is losing popularity world wide. Has gone from most popular surgery in 2006 at 60% to less than 10% today.
WLS DOES NOT OFFER THIS OPTION BECAUSE IT IS LIKE ANY OTHER DIET – NOT PERMANENT!To be considered by patients with BMI=30-35 kg/m2 (with no obesity associated disease like diabetes) who are more disciplined and can follow dietary restrictions.

This is a TEMPORARY solution to obesity as the balloon must be removed after 6 months.

It is just like going on another type of diet!!!

Dr. Christou’s main reservation is the lack of long term weight loss results.