Sometimes called a bilio-pancreatic diversion with duodenal switch (BPD-DS), this procedure goes beyond a normal gastric sleeve procedure. Like a gastric sleeve, this procedure eliminates a majority of the stomach and forms it into a shape of a banana. Unlike a gastric sleeve, a duodenal switch also means that the lower intestine is divided. Roughly two-thirds of the intestine is operated on so that food and enzymes cannot be absorbed fully.