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Duodenal Switch Surgery

What is Duodenal Switch Surgery? 

The duodenal switch, also known as the biliopancreatic diversion with duodenal switch or DS for short, is a complicated and less commonly performed procedure. At our practice, we typically recommend the duodenal switch procedure for our heavier patients. The duodenal switch weight loss surgery is a combination of the gastric sleeve and gastric bypass. Therefore, this procedure is non-reversible. 

How it Works

In performing the duodenal switch, the surgeon creates a sleeve gastrectomy by removing a significant portion of the stomach. Then, the surgeon will divide the small intestine just beyond the stomach as well as about 75% downstream. The lower portion of the intestine is connected to the stomach while the upper portion is reconnected further downstream.

As a result, food will travel down one path, and the digestive juices will travel down another. The food and digestive juices will meet up again approximately 75% further downstream. This results in significant malabsorption. 

This operation is not only shrinking the stomach size but is also shortening the small intestine by about 75%. Thus, resulting in smaller portions of food consumed and the faster movement of food through your digestive system.

The duodenal switch weight loss surgery takes about 3 hours to perform, and patients can expect to stay at the hospital for up to 2 days after surgery. Depending on the type of work performed, patients will be able to return to work within 2 to 4 weeks from surgery.  

Benefits of Duodenal Switch Surgery

Patients who have the duodenal switch weight loss surgery can expect to lose 80 to 100% of their excess body weight within the first year.
*Excess body weight is the percentage of how much weight was lost based on how much you have or want to lose.
Weight loss surgery benefits bariatric clinic in Georgia
Improvement or resolution of serious medical conditions
Cost Savings as a benefit of weight loss surgery in Georgia
Long term cost savings as a result of reduced medical care
Improvement in health as a benefit of weight loss surgery in Georgia
Improvement in overall health and quality of life

Risks of Duodenal Switch Surgery

Before considering the duodenal switch procedure, you should be familiar with the potential risks.
Minor complications that uncommon and can be managed fairly easily: 
  • Minor wound or skin infection
  • Loose/excess skin
  • Vomiting or nausea
  • Acid reflux (heartburn)
  • Changes in bowel habits like diarrhea, bloating, cramping, or gas
  • Development of gallstones or gallbladder disease
  • Nutritional deficiencies
Major complications, that could result in re-operation: 
  • Internal bleeding
  • Intestinal obstruction
  • Blood clots in the legs or lungs
  • Internal Hernia
  • Perforation of stomach/intestines or leakage

Frequently Asked Questions 

Duodenal Switch Surgery

Should I get the duodenal switch or the gastric bypass?
The duodenal switch and gastric bypass both have restrictive and malabsorptive components in which a new connection between the stomach and small intestine is surgically created. The duodenal switch has a higher level of malabsorption though. This leads to more weight loss when compared to the gastric bypass. The duodenal switch is best performed on patients with a BMI greater than 60, who are looking for better results. However, it is important to keep in mind the risks and lifestyle changes that come with the duodenal switch. 
How much weight will I lose after duodenal switch surgery?
Research shows that patients will lose between 80 and 100% of their excess weight. Patients who achieve greater success after duodenal switch surgery are those individuals who follow their surgeon and dietitians' instructions and incorporate exercise into their daily activities. 
Who is a good candidate for duodenal switch surgery?
Patients who are looking to have the duodenal switch must first qualify for bariatric surgery. To qualify, you must have a BMI over 40, however for patients seeking the duodenal switch procedure, we recommend they have a BMI greater than 60 and weight-related medical conditions (i.e. diabetes, sleep apnea, heart disease, etc.). Patients who are interested in the duodenal switch must also be committed to a life long change in their eating habits and lifestyle. This procedure is non-reversible, therefore deciding to have a duodenal switch is a serious decision. Due to the malabsorptive nature of this procedure, patients must be committed to taking their vitamins for life after surgery.  Nonetheless, candidates for duodenal switch surgery can expect to lose a significant amount of weight and experience a better quality of life. 
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