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Duodenal switch

What is duodenal switch?

The duodenal switch is a minimally invasive procedure or open surgical procedure that combines a sleeve gastrectomy (restriction) with a bypass of the intestines (malabsorption). This procedure is associated with the highest average weight loss.

People who undergo this surgery must commit to life-long vitamin supplementation and a diet of protein-dense foods. Furthermore, careful monitoring and ongoing education are essential in reducing incidence of nutritional side effects.

Why it's done

As compared to other bariatric procedures, it provides more consistent weight loss results for super morbidly obese patients (those with a Body Mass Index greater than 50). Accordingly, it is similarly associated with high rates of improvement in or resolution obesity related health problems, like diabetes, hypertension and sleep apnea, and lowest chance of relapsed weight regain.

Benefits of duodenal switch:

  • Highest average weight loss
  • Excellent long term maintenance of weight loss
  • High rate of improvements in obesity related medical problems
  • Avoids dumping syndrome

Risk factors

There are various factors to consider when exploring weight loss surgery—all of which should be discussed with your bariatric surgeon. Complications associated with duodenal switch are different for everyone. The duodenal switch is the most technically complicated procedure. Possible risks include:

  • Leaks from stomach or intestine
  • Vitamin, calcium and iron deficiencies
  • Protein and fatty acid deficiencies
  • Frequent bowel movements or diarrhea and or flatulence

Proper education and supplement intake can reduce complications. This procedure is not reversible. Discuss all potential risks with your doctor.

What to expect 

Duodenal switch surgery is performed in a hospital setting with a 1 to 3 day hospital day and can be done laparoscopically with or without the robot or as an open procedure. It combines a slightly less extensive version of the gastric sleeve with a substantial intestinal bypass.

The gastric sleeve provides the restrictive element of the procedure by limiting the amount of food you take in. The bypass element decreases the ability of the intestine to absorb calories (particularly fat calories). The combination of these two elements results in weight loss.

Recovery

Minimally invasively performed duodenal switch patients are usually discharged within 1 to 3 days and return to work an average of 1 to 2 weeks.

After your surgery, follow-up visits and post-surgical testing at your doctor’s office is required. Patients should be followed by a physician that is qualified to manage post bariatric patients. These appointments are made so that your doctor can keep a close eye on your progress and assist in the overall success of your surgery. In the duodenal switch procedure, long term follow up is particularly important.

Results

People who undergo the duodenal switch procedure typically lose a majority of their excess body weight and keep it off. Medical problems such as high blood pressure and diabetes often resolve. It is also associated with the lowest rates of significant weight regain.

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