Duodenal Switch

The Traditional Duodenal Switch is a hybrid of the sleeve and the bypass. It starts by creating a tube-shaped stomach pouch, similar to a sleeve gastrectomy. It is somewhat like a gastric bypass, but more of the small intestine is bypassed. This limits the amount of food the stomach can hold and reduces calorie absorption, leading to substantial weight loss. There is a variant of the traditional switch called the SADI-S or SIPS procedure which is gaining popularity.

The Procedure

After forming the sleeve-like stomach, the first part of the small intestine is detached from the stomach. A section of the small intestine is then connected to the outlet of the new stomach, so food passes through the sleeve pouch directly into the latter part of the small intestine. In a traditional switch, a second connection is made that diverts the bile farther downstream.  

How it Works

The banana-shaped, smaller stomach limits food intake. Approximately 75% of the small intestine is bypassed, significantly reducing calorie and nutrient absorption. Patients need to take vitamins and mineral supplements post-surgery. The BPD-DS influences intestinal hormones more than gastric bypass and sleeve gastrectomy, reducing hunger, increasing fullness, and improving blood sugar control. It is considered the most effective approved metabolic surgery for type 2 diabetes. Additionally, it enhances GLP-1 levels in your body. This hormone is being augmented/amplified by Ozempic, Wegovy, Mounjaro, and Zepbound.

Advantages

Disadvantages

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Photo courtesy of Medtronic

Frequently Asked Questions

Most patients lose between 70-80% of their excess weight within the first year after surgery.

Yes, due to changes in the digestive system, patients will need to take vitamins and supplements for the rest of their life to prevent nutritional deficiencies.

Most patients can return to work within 2-4 weeks, depending on the nature of their job and their individual recovery.

Patients will most likely need to supplement with a protein shake and/or bar at least once a day and you may need to break up your daily meals/nutrients into 5-6 smaller meals versus 2-3 meals.

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