Duodenal Switch
Duodenal switch surgery begins with a vertical sleeve gastrectomy. This is intentionally slightly larger than when gastric sleeve surgery is performed as a stand-alone procedure.
The aim is to increase the intake of protein-rich foods.
The digestive tract has a valve known as the pylorus. Marks the boundary between the stomach and the first part of the intestine, or duodenum. Approximately 2.5 cm beyond this boundary, the duodenum divides. An intestinal bypass is performed to restore the pathway to food. Classically, this was done in the same manner as the Roux-en-Y gastric bypass. However, more intestine is bypassed in the duodenal switch procedure. As a result, this surgery is called malabsorption, meaning that some of the nutrients ingested with food are not absorbed into the intestine. This makes additional nutritional supplementation necessary for effective nutrition.
In theory, duodenal switch surgeries can be performed on any patient who meets the general requirements for bariatric surgery (see the BMI calculator). As compared to other bariatric procedures, DS surgery and its modifications have a better chance of helping patients with super morbid obesity to meet their weight loss goals. It also is more effective than other procedures for diabetes, especially in patients requiring insulin therapy for a prolonged period of time. However, this effectiveness needs to be balanced with the higher risk of nutritional deficiencies.
