Lap Band Versus Gastric Sleeve

Lap Band Versus Gastric Sleeve

As obesity continues to grow all around the world the medical community continues to find tools or solutions to combat it.

Two of the most popular of these are Lap Band and Gastric Sleeve surgery.

But what is the difference between them and is one better than the other?

Firstly, let’s look at the differences between a lap band and gastric sleeve:

Lap Band:

Lap Band surgery is when an adjustable ring is placed around the top of the stomach, effectively making a small ‘pouch’ whilst still leaving the large part of the stomach (the fundus) in-tact. The ring can be adjusted to add more restriction or alternatively reduce it which will adjust the volume of food that the patient can eat.

Gastric Sleeve:

The Gastric Sleeve is when between 65-75% of the stomach is surgically removed. Not only does this reduce the total volume of food a person can consume but it also has a secondary benefit as the removal of the fundus (large sack part of the stomach) also reduces the amount of ghrelin hormone or hunger hormone as this is predominately produced in the fundus. This gives a two-pronged approach as patients are both physically restricted with how much they can eat whilst also having their appetite suppressed and reduced cravings.

Although both surgeries have had success in assisting weight loss there are some significant pros and cons between them.

Pros and Cons of the Lap Band


  • Reversible
  • Less invasive & faster recovery
  • Restricts the total volume of food eaten
  • Can be adjusted to allow more or less restriction


  • Continued feelings of hunger and ‘need’ for more food as the ghrelin (hunger) hormone is not altered which leads to poor satiety.
  • Complications with the band ‘slipping’ and needing to be adjusted.
  • Low tolerance to heavier/textured foods such as salad, meat, bread etc
  • Low rate of overall weight loss. Approx. only 11-12% of patients achieve desired weight loss
  • On average more than 50% of patients have the band removed due to complications

Pros and Cons of Gastric Sleeve


  • Restricts total volume of food that can be eaten
  • Lowers the production of the hunger hormone (Ghrelin) which leads to appetite suppression
  • Able to eat a varied whole food diet
  • More than 75% of patients see desired weight loss over the first 12-18mths.


  • Irreversible
  • Potential ‘dumping syndrome’ if patients over-eat
  • More invasive surgery which requires a longer recovery

So, which one is better?

If we compare the lists of pros and cons of both surgeries, the Gastric Sleeve certainly provides a better long-term outcome even though it is a more invasive surgery.

However as with all surgeries we recommend doing your research and speaking to several Bariatric surgeons and listening to their expert advise. Everyone is unique so it’s always best to make an informed decision based on your individual needs before deciding which procedure is best for you.