Journal Review in Bariatric Surgery: Sleeve vs Bypass and Revisional Strategies

  • Sleeve, bypass, or something new – which surgery really dominates the day?  This Bariatric Surgery Journal Club dives into the debate over which bariatric operation is best. We compare the outcomes of the gastric bypass, sleeve gastrectomy, and the newer Sadie procedure, exploring how bypass may have an edge in long-term diabetes remission and weight loss.  We also discuss revisional options for failed sleeves and the importance of matching the patient to the right operation for their specific needs.

Target Audience

  • Nurses
  • Nurse Practitioners
  • Physicians
  • Physician Assistants

Learning Objectives

  • Describing the design and unique triple-blind methodology of a single-center randomized trial comparing bypass and sleeve in patients with obesity and type 2 diabetes.
  • Interpreting the clinical relevance of the 5-year outcomes, including 63% diabetes remission with bypass vs 30% with sleeve.
  • Examining secondary outcomes such as weight loss and cholesterol reduction, which favored bypass over the sleeve. 
  • Formulating patient-centered strategies for selecting bypass versus sleeve in populations with advanced metabolic disease, balancing efficacy with patient preference  
  • Summarizing the findings of this multi-center, open-label randomized controlled trial of over 1,300 patients comparing bypass, sleeve, and gastric banding at 5 years
  • Discussing the relative weight loss outcomes: 67% excess weight loss for bypass, 63% for sleeve, and 28% for adjustable gastric band. 
  • Evaluating the improvements in diabetes remission, hypertension control, and lipid management with bypass and sleeve compared to banding.
  • Analyzing the declining role of gastric banding in modern bariatric surgery, while acknowledging its benefits compared to no weight loss treatment
  • Comparing long-term outcomes of bypass versus SADI after failed sleeve gastrectomy, based on pooled analysis of over 1,000 patients.
  • Interpreting the trade-offs: SADI provides greater weight loss and metabolic improvements, but carries a higher risk for malnutrition and fat-soluble vitamin deficiencies
  • Developing strategies for preoperative counseling, nutritional supplementation, and close long-term monitoring, particularly for patients undergoing SAD
  • Individualizing decision-making for revisional surgery, considering factors such as patient goals, comorbidity burden, prior anatomy, BMI, and reliability with follow-up,
  • Evolving revisional strategies will influence the next decade of bariatric surgical innovation 
Course summary
Available credit: 
  • 0.75 AMA PRA Category 1 Credit(s)™
  • 0.75 ANCC
  • 0.75 Attendance
  • 0.08 IACET CEU
Registration Opens: 
11/15/2025
Registration Expires: 
11/14/2027
Part of: 
Behind the Knife Podcast (July-Dec 2025)
Rating: 
0
Virtual, NC
United States
  • Timothy Vreeland, MD,
  • Lexy (Alexandra) Adams, MD, 
  • Beth (Elizabeth) Barbera, MD 
  • Joe (Joseph) Broderick, MD
  • Galen Gist, MD 

 

  • AMA PRA Category 1 Credit(s)
  • ANCC
  • Attendance
  • JA Credit - AH

Available Credit

  • 0.75 AMA PRA Category 1 Credit(s)™
  • 0.75 ANCC
  • 0.75 Attendance
  • 0.08 IACET CEU
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