Duodenal Switch Surgery

Success Stories

The Duodenal Switch (DS)

Also known as biliopancreatic diversion with duodenal switch (BPD-DS), it is a complex weight-loss surgery that combines restrictive and malabsorptive techniques to achieve significant weight loss and improve obesity-related conditions.

Procedure

• Sleeve Gastrectomy: About 70-80% of the stomach is removed, creating a smaller, tube-shaped stomach (sleeve) that limits food intake.
• Intestinal Bypass: The small intestine is divided, and a portion is bypassed to reduce calorie and nutrient absorption. The remaining part of the small intestine is connected to the stomach sleeve.

Average Surgery Time

The surgery typically takes about 3 to 4 hours. This duration can vary depending on the patient’s specific circumstances and the surgeon’s experience.

How It Works

• Restriction: The smaller stomach limits the amount of food you can eat.
• Malabsorption: Bypassing a portion of the small intestine reduces the absorption of calories and nutrients.
• Hormonal Changes: The surgery alters gut hormones, reducing hunger and improving satiety.

Recovery Period

• Hospital Stay: Most patients stay in the hospital for 1 to 2 days. This will depend on the patient’s recovery after surgery.
• Full recovery usually takes about 4-6 weeks, during which patients gradually transition from a liquid diet to solid foods using the post-operatively dietary guidelines.

Potential Complications

• Nutritional Deficiencies: Due to the malabsorptive nature of the surgery, patients are at risk for deficiencies in vitamins and minerals such as iron, calcium, vitamin D, and B12. Lifelong supplementation and regular monitoring are essential.
• Malnutrition: Inadequate absorption of nutrients can lead to protein and fatty acid deficiencies.
• Gastrointestinal Issues: Patients may experience frequent bowel movements, diarrhea, and flatulence.
• Leaks: There is a rare risk of leaks from the stomach or intestines, which can lead to serious infections.
• Blood Clots: The risk of blood clots, including pulmonary embolism, is present, especially in the immediate post-operative period.
• Pneumonia: Post-operative pneumonia can occur, particularly if patients have difficulty with deep breathing and coughing after surgery.

Long-Term Considerations

• Weight Loss Expectations: Patients can expect to lose about 75% to 85% of their excess body weight within three years. This weight loss is typically maintained long-term, especially with adherence to dietary and lifestyle changes.
• Lifelong Supplementation: Patients must commit to taking vitamins and minerals for life to prevent deficiencies.
• Regular Follow-Ups: Ongoing medical check-ups are necessary to monitor nutritional status and manage any complications.
• Dietary Adherence: Following dietary guidelines is crucial to avoid gastrointestinal issues and ensure adequate nutrient intake.

Modified Duodenal Switch also known as Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S)

The Modified Duodenal Switch, also known as Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S), is a less invasive version of the traditional duodenal switch. It combines a sleeve gastrectomy with an intestinal bypass but with only one connection (anastomosis) instead of two, which simplifies the procedure and reduces the risk of complications. Here’s a breakdown of how it works and the potential complications:

Procedure

• Sleeve Gastrectomy: About 80% of the stomach is removed, leaving a tube-shaped stomach (sleeve) that restricts food intake.
• Intestinal Bypass: The small intestine is divided just below the stomach, and a loop of the small intestine is connected to the stomach. This bypasses a significant portion of the small intestine, reducing calorie and nutrient absorption.

Average Surgery Time

The surgery typically takes about 2-3 hours. This can vary depending on the patient’s surgical history and anatomy. This duration can vary depending on the complexity of the case and the surgeon’s experience.

How It Works

• Restriction: The smaller stomach limits the amount of food you can eat.
• Malabsorption: Bypassing a portion of the small intestine reduces the absorption of calories and nutrients.
• Hormonal Changes: The altered digestive tract changes levels of gastrointestinal hormones, reducing hunger and increasing feelings of fullness.

Recovery:

• Most patients stay in the hospital for 1 day after the surgery.
• Full recovery usually takes about 4-6 weeks, during which patients gradually transition from a liquid diet to solid foods using the post-operatively dietary guidelines.

Potential Complications

• Nutritional Deficiencies: Due to the malabsorptive nature of the surgery, patients are at risk for deficiencies in vitamins and minerals such as iron, calcium, vitamin D, and B12. Lifelong supplementation and regular monitoring are essential.
• Malnutrition: Inadequate absorption of nutrients can lead to protein and fatty acid deficiencies.
• Gastrointestinal Issues: Patients may experience frequent bowel movements, diarrhea, and flatulence.
• Leaks: There is a rare risk of leaks from the stomach or intestines, which can lead to serious infections.
• Blood Clots: The risk of blood clots, including pulmonary embolism, is present, especially in the immediate postoperative period.
• Pneumonia: Postoperative pneumonia can occur, particularly if patients have difficulty with deep breathing and coughing after surgery.

Long-term Considerations:

Weight Loss Expectations: Patients who undergo modified duodenal switch/SADI surgery typically 70% to 80% of their excess body weight within three years. This weight loss is typically maintained long-term, especially with adherence to dietary and lifestyle changes.

FAQs About Duodenal Switch Surgery