Duodenal switch is a weight-loss procedure combining intestinal bypass and gastrectomy. The surgery is primarily suitable for individuals with severe obesity.

What is Duodenal Switch Surgery?

Duodenal switch is a complex weight-loss procedure primarily reserved for individuals with severe obesity. It combines two techniques:

Gastrectomy: removing part of your stomach.

Intestinal bypass: rerouting your intestines.

The surgery limits how much your stomach can hold and reduces the nutrients your intestines can take from food. The surgery also cuts down on hunger hormones from your stomach and intestines.

Who is the right candidate? Why is it done?

Duodenal switch treatment is generally performed for those who have obesity. If you cannot lose weight through traditional methods and treatments, you may get an appointment with your doctor to check your surgical options. You may be a good candidate for duodenal switch operation if you fulfill the criteria below:

• You need to have a high body mass index, which is a BMI of 40 or more.
• If your BMI is between 35 and 39 but is accompanied by serious obesity-related health issues like type 2 diabetes, high blood pressure, heart disease, lung disease, high cholesterol, or sleep apnea, this surgery might be suitable for you.
• If you have tried traditional methods such as diet or exercise and could not lose weight, you might consider having duodenal switch surgery.
• You need to be prepared to make significant and lifelong changes in your diet and lifestyle, such as adhering to dietary guidelines, taking supplements, and engaging in regular physical activity.

Types of Duodenal Switch Surgery

Duodenal switch treatment combines two different types of surgery for weight loss.

Restrictive Weight Loss

The restrictive part of the duodenal switch surgery focuses on reducing the size of your stomach. This is done by removing a large portion of it, like a sleeve gastrectomy. After the surgery, your stomach can hold much less food than before. This limitation means you will feel full quicker and eat less, aiding in weight loss.

Malabsorptive Element

The malabsorptive aspect of this surgery changes how your body absorbs food. By rerouting and bypassing a significant part of your small intestine, the surgery ensures that your body absorbs fewer calories and nutrients from the food you eat. This is a key factor in weight loss, as the reduced absorption contributes significantly to the overall effect of the surgery.

How is Duodenal Switch Surgery Done?

Duodenal switch, or DS in short, is a surgery containing several steps for the whole procedure. You can check below to get brief information about the process:

Choosing the Surgical Approach

Laparoscopic Surgery

This modern technique involves making small incisions and using specialized instruments. It is favored for its minimal invasiveness, reduced pain, and quicker recovery.

Open Surgery

In some cases, traditional open surgery might be necessary. It involves a larger incision and is typically used when laparoscopic surgery isn't suitable.

Step-by-Step Surgical Process

Step 1: Sleeve Gastrectomy

The first phase of the DS procedure is reducing the size of the stomach. About 65% of the stomach is removed, leaving a smaller, tube-like stomach. This limits the amount of food you can eat and helps you feel full faster.

Step 2: Intestinal Bypass

The next phase of losing weight surgery involves rerouting a portion of the small intestine. This process creates two pathways and a common channel. The shorter path for food limits calorie and nutrient absorption, aiding in weight loss.

Two Methods of Duodenal Switch

Original Duodenal Switch (Biliopancreatic Diversion)

This method involves bypassing a larger portion of the small intestine (about 80–90%). It's more effective for weight loss but has a higher risk of nutritional deficiencies.

Modified Duodenal Switch (Loop DS)

A less extensive version bypasses about 50–60% of the small intestine. This method is simpler and has a lower risk of nutritional deficiencies.

Post-Surgery Care for DS Switch Surgery

Duodenal switch requires comprehensive follow-up and post-surgery care. Because, after the surgery, you will need to ensure long-term results, which are possible with an aftercare procedure.

• You will start with a liquid diet and gradually move to solid foods, focusing on small, nutrient-rich meals and necessary supplements such as Vitamin A, D, K, B12, etc.
• You will incorporate regular exercise into your daily routine and ensure you are staying well-hydrated. But you should avoid drinking too close to mealtimes.
• To monitor your recovery, you should visit your doctor regularly.
• If you experience any complications, like excessive pain or fever, you should contact your doctor.

Risks and Benefits of Weight Loss Operation

Duodenal switch helps you lose more weight and reduces your ability to gain weight by preventing you from absorbing calories, minerals, or vitamins. The procedure of the gastric switch, of course, offers both risks and benefits.

Benefits

• Significant and rapid weight loss
• Improved obesity-related conditions
• Reduced hunger
• Better life-quality
• Long-lasting weight loss results

Risks

• Vitamin and mineral deficiencies
• Surgical complications such as infection, bleeding, etc.
• Potential risks include diarrhea, nausea, vomiting, etc.