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Please visit http://www.doctormarvin.com/appointme... or call 713-993-7124 to schedule an appointment with Dr. Marvin at Houston Surgical Specialists. Dr. Marvin: The difference with the sleeve, compared to the gastric bypass, is that there is no malabsorptive component to the surgery. It avoids some of the long-term issues that can happen with the gastric bypass. In particular, there are very few vitamin and mineral deficiencies later, because everything goes down the normal way. The gold-standard operation, of course, is the gastric bypass. It's been around for 50 years. It has very predictable weight loss. What we're seeing is patients who are a year out from surgery who have lost 60, 70, or 80 percent of their extra body weight. Jean: I had what's call the Roux-en-Y. It's where they make a small pouch out of the stomach, and they divert part of the intestine so that I have a little bit of malabsorption. So I have to supplement my diet with several vitamins that would otherwise not be absorbed through part of the intestines. Dr. Marvin: Jean had gone and had a lap-band operation done previously with another surgeon and, like some of the lap-band patients, what she'd experienced was a frustrating cycle of having the band adjusted to a certain tightness and getting some difficult symptoms from that, only to have it loosened to make those symptoms go away and then losing a little bit of weight and then gaining it back. She has lost somewhere in the neighborhood of two-thirds of her extra body weight from the level she was at the gastric bypass. Two-thirds of the weight has gone away. Jean: My friends comment that I have more pep in my step, and I'm able to work more days in a row and longer hours and not feel fatigued. Dr. Marvin: If I look at the breakdown for the last twelve months, it appears that about 74% of the patients are choosing the laparoscopic sleeve gastrectomy. Most of the rest of the patients are choosing a gastric bypass, and we're doing very few lap-bands currently. Mostly because the weight loss just isn't as predictable with the lap-bands, and there are some long-term issues. Jean: Go to the seminars, especially Dr. Marvin, who is very open, explains things in a very simple way for everyone to understand. We have numerous support groups here in Houston, and that has been my main success.