Duodenal Switch Procedure
Some bariatric surgeries involve reducing stomach size so that patients feel more full, resulting in a lower caloric intake. Other bariatric procedures have a completely different approach: reducing caloric absorption. However, there is a procedure that does both: physically reducing stomach size while also significantly limiting nutrient entry into the bloodstream. That procedure is called a duodenal switch (DS).
How a Duodenal Switch Works
Like other bariatric procedures, the duodenal switch (often referred to as a biliopancreatic diversion with duodenal switch) involves a 70% reduction of the stomach; however, the procedure also re-routes food to a later portion of the small intestine, maintaining the natural connection between the stomach and small intestine, while bypassing major absorptive regions of the small intestine.
A duodenal switch changes the stomach from its bag-like structure to that of a small tube while also re-routing the accessory organs’ excretions in order to limit nutrient absorption.
Candidates for a Duodenal Switch Procedure
This dual attack may very well be the most effective bariatric surgery for short and long term weight loss, high cholesterol and other obesity-associated conditions. It has over a 97% resolution rate for type II diabetes. Because of its intense, multi-faceted attack, this surgery is only recommended for the severely obese (those with a BMI greater than 50) and may not be the optimal choice for certain high risk individuals with heart complications and other chronic diseases. Together with your healthcare provider the best surgical weight loss procedure will be chosen to give you the best and safest results.
Duodenal Switch Surgery
Preparation: A duodenal switch is one of the most complicated bariatric surgeries, so diet modification may need to start two to three months before the surgery itself to prep the digestive system.
Generally, pre-op diets require the following changes:
- Limit fats and carbohydrates
- Stop smoking and limit alcohol
- Protein supplements (important for recovery)
- Medication evaluation
Procedure: A duodenal switch can be done as an open procedure with a large cut in the stomach or laparoscopically by using small tools and a camera. It can last for up to 6 hours, which is longer than other bariatric procedures due to the technically advanced nature of it.
Recovery: Post-operation involves a 2-3 day stay in the hospital for monitoring. For open surgery, it typically takes 4-6 weeks for full healing, as opposed to a 1-2 week recovery for a laparoscopic operation. Immediately after surgery, the site of incision will be sore and medication will be prescribed for pain management. Physical activity should be limited to avoid tears and leakage. Normal activity can often resume within 3-4 weeks. After surgery, walking is critical. Risks such as deep vein thrombosis (blood pooling in the legs) and pulmonary embolism (blood clot in the lung) increase after bariatric surgery and walking helps to minimize the chances of either developing.
The stomach will only be able to tolerate a limited amount of food, and eating beyond capacity will result in pain and possibly even vomiting. Due to the reconstructive nature of the surgery, the reintroduction to food should be taken step by step:
- Week 1: Restrict to liquid diet so that stomach can heal and has limited pressure. Avoid using a straw so that extra air does not enter the digestive tract and cause pressure. Caffeinated and sugary drinks should be avoided.
- Week 2-3: Pureed food
- Week 4: Ease into solid foods
Your healthcare provider will give you full post-op diet instructions which must be followed appropriately to ensure healing and weight loss success.
Long-term Recovery: Typically, 12-18 months post-surgery there is dramatic weight loss (75-85% of excess weight) that may last as long as three to five years, regardless of lifestyle habits, however results vary for every patient. For longevity and prevention of weight gain, positive lifestyle changes are critical.
To avoid malnutrition, an aggressive dietary supplement regimen is prescribed and can include fat soluble vitamins, zinc, iron and calcium. Follow-up appointments with your healthcare provider after your procedure are an important part of the recovery process in order to monitor your nutrition and overall healing.
As with all surgical weight loss procedures, risks are involved. Complications related to the duodenal switch procedure include an incision infection, blood clots, vitamin deficiencies and gastrointestinal complications. Your healthcare provider will review all the surgical risks with you prior to your procedure.
Request more information about receiving a duodenal switch procedure today. Call (470) 419-4380 or contact us online.