The duodenal switch (DS) procedure is a weight loss surgery procedure that is both restrictive and malabsorptive. The Duodenal Switch is a laparoscopic procedure. The surgeon works with instruments and a camera inserted through small incisions in the abdomen.
Duodenal Switch: How does it work?
The restrictive portion of the surgery involves removing approximately 2/3 of the stomach (along the greater curvature).
The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the alimentary limb, takes food from the stomach to the common channel. The longer pathway, the biliopancreatic limb, carries bile from the liver to the common channel.
The common channel is the portion of small intestine, about 100 centimeters long, where the food mixes with the digestive juices from the biliopancreatic limb before emptying into the large intestine. The purpose is to reduce the amount of time the body has to absorb calories from food in the small intestine and to reduce the absorption of fat. As a result, following surgery, these patients absorb only approximately 30% of the fat they intake.
The malabsorptive component of the DS requires that those who undergo the procedure take more vitamin and mineral supplements than any other surgical procedure for the rest of their lives.
Duodenal Switch: What are the advantages?
- Combination of restriction and malabsorption results in a higher percentage of excess weight loss.
- Average percent excess weight loss is 75% at 15-20 years
- >90% Diabetes resolution
- Resolution of Hyperlipidemia (80%), Metabolic Syndrome(89%), and Hypertension(60%).
Duodenal Switch: What are the risks?
- Vitamin and mineral deficiencies. The malabsorptive component of the DS requires that those who undergo the procedure take vitamin and mineral supplements including Multivitamin, Iron, Calcium, Vitamins A, D, B12 and E.
- Bowel Issues
- Bacterial Overgrowth
- Flatulence and malodorous gas
- Increased Bowel Frequency
- 1-2% Risk of Malnutrition
- 5% Risk of Weight Regain