Duodenal Switch Surgery
Bariatric surgical procedures that alter the gastrointestinal tract change signals that connect the gut to the brain and drastically increase the probability of lasting significant weight loss. This occurs even in individuals that have previously struggled to lose weight.
Duodenal switch surgery (DS) is a procedure that results in the greatest overall weight loss. In addition, it offers the best control of metabolic conditions, like diabetes. This particular bariatric procedure is less common because it is more complex; patients must commit to life-long vitamin supplementation and a diet of protein-dense foods. Further, physicians and the bariatric team must carefully monitor patients and provide education to reduce incidence of nutritional side effects.
At Lenox Hill Bariatric Surgery Program, we are local leaders in duodenal switch surgery, offering expertise and experience for patients seeking maximum weight loss.
What Is Duodenal Switch Surgery?
Duodenal switch surgery begins with a vertical sleeve gastrectomy that is intentionally made slightly larger than when a gastric sleeve surgery is performed as a stand-alone procedure. The purpose of this is to allow for greater intake of foods with a high protein content.
Within the digestive tract, there is a valve known as the pylorus. that marks the border between the stomach and the first portion of the intestine, or the duodenum. Approximately one inch past this border, the duodenum is divided. To reestablish a channel to food, an intestinal bypass is performed. Classically, this has been done in an identical manner as a Roux-en Y Gastric Bypass. However, in a duodenal switch procedure, more bowel is bypassed. As a result, the surgery is labeled as malabsorptive, meaning that some of the nutrients consumed in food are not absorbed by the intestine. This results in a need for extra supplementation for effective nutrition.
The Duodenal Switch procedure for weight loss was developed by Dr. Douglas Hess in Ohio, while significant research demonstrating its long term effectiveness has come from Quebec in Canada. Our own Dr. Mitchell Roslin has been a large proponent for modifications of DS surgery. He has highlighted that the operation reduces the fluctuations in blood sugar that are commonly seen in gastric bypass. Dr Roslin has advocated bypassing less bowel to reduce the risk of nutritional deficiencies and diarrhea.
Who Should Have Duodenal Switch Surgery?
In theory, duodenal switch surgeries can be performed on any patient who meets the general requirements for bariatric surgery (see the BMI calculator). As compared to other bariatric procedures, DS surgery and its modifications have a better chance of helping patients with super morbid obesity to meet their weight loss goals. It also is more effective than other procedures for diabetes, especially in patients requiring insulin therapy for a prolonged period of time. However, this effectiveness needs to be balanced with the higher risk of nutritional deficiencies.
The Lenox Hill bariatric program and its surgeons are internationally acclaimed experts in this complex procedure. They have trained other surgeons and have been featured on multiple live telecasts. Our staff is highly proficient in clarifying the advantages and the issues patients having this procedure may confront.
What Are the Benefits and Risks of Duodenal Surgery?
- Maximal weight loss with lowest rate of weight regain
- Dumping syndrome does not occur with this surgery
DS surgery patients should be aware of the potential drawbacks, including:
- Vitamin, calcium and iron deficiencies
- Increased risk of protein and fatty acid deficiency
- Increased risk of frequent bowel movements or diarrhea.
If you have been considering duodenal switch surgery, Lenox Hill Bariatric Surgery Program can help you make the right decision for you. Attend one of our Educational Bariatric Seminars or give us a call at 1-888-949-9344 to learn more!
*Results may vary.