Bariatric Procedure Comparison

Sleeve Gastrectomy vs. Roux-en-Y Gastric Bypass vs. SADI-S

Thinking About a Sleeve Gastrectomy?

Here’s what you should know before you decide.

If you’ve been researching weight loss surgery in Ontario, you’ve probably come across the sleeve gastrectomy more than any other option. There’s a simple reason for that — until recently, it was the only procedure most private surgical practices in Ontario were able to offer. But that has changed, and it means you now have access to options that the evidence shows work better.

At Vital Surgicalwe offer the full spectrum of bariatric surgery, including procedures that have been available in Alberta and internationally for years but are only now becoming accessible privately in Ontario: SADI-S and Roux-en-Y Gastric Bypass. We believe you deserve to make your decision with complete information.

The Question Worth Asking

If you’re considering surgery, the most important question isn’t “what’s available?” — it’s “what gives me the best chance of lasting success?”

For most patients, that answer is gastric bypass or SADI-S.

We’ll never push you toward a particular procedure. But we will make sure you have the full picture — including the long-term data — before you make one of the most important health decisions of your life.

So What’s the Difference?

Weight loss surgery isn’t one-size-fits-all. The three main procedures work in different ways and produce meaningfully different results — especially over the long term.

The sleeve gastrectomy removes roughly 80% of the stomach, creating a smaller, tube-shaped stomach. It’s a straightforward operation with a solid track record. For some patients, it’s still a reasonable choice. But the honest picture is more complicated: weight regain over time is common, diabetes remission rates are lower than other options, and a significant number of patients develop acid reflux after surgery — sometimes severe enough to eventually require a second procedure.

Roux-en-Y Gastric Bypass has been the gold standard of bariatric surgery for decades. It combines a smaller stomach with a rerouting of the small intestine, which does something remarkable: it doesn’t just restrict how much you eat, it changes your metabolism at a hormonal level. The result is stronger, more durable weight loss, dramatically better diabetes remission rates, and — importantly — it actually treats acid reflux rather than causing it.

SADI-S (Single Anastomosis Duodeno-Ileal Bypass with Sleeve) is the newest of the three and, in many ways, the most powerful. It pairs the sleeve with a single intestinal bypass that dramatically improves metabolic outcomes. Studies show the highest rates of total weight loss and Type 2 diabetes remission of any bariatric procedure currently available. It’s particularly well-suited for patients with higher BMI or those for whom diabetes remission is the primary goal.

Ready to Learn More?

Book a consultation with Dr. Schofield to discuss which procedure is the right fit for your goals, your health history, and your life.