Duodenal Switch

What is Duodenal Switch Surgery?

Duodenal weight loss surgery helps shorten the path food follows through the small intestine. In turn, this reduces the time your body has to absorb calories from the food you eat to help you lose weight.

This type of surgery is minimally invasive, but your doctor must check the condition of your gastric sleeve as the surgery can only be done if the stomach sleeve and opening to the duodenum are healthy.

The surgery involves three steps:

1. The surgeon cuts the small intestine in two places: across the duodenum just below the pylorus and about halfway into the intestine. This leaves two sections of small intestine, each about 8-10 feet long.
2. Surgeon sews and staples the top of the first section of intestine closed and attaches the bottom to the second section, about 3 feet from where the small intestine meets the large intestine.
3. When the surgeon attaches the second part of the small intestine to the pylorus where the duodenum used to be, the duodenal switch is complete.

Once surgery is complete, the food from the stomach will now move through about 10 feet of small intestine instead of 20, reducing the time it takes for the body to absorb calories and nutrients, prompting weight loss.

What to Expect from Duodenal Switch Surgery

Here’s what to expect before undergoing duodenal switch surgery:

• Duodenal switch surgery is performed in a hospital.
• The length of a patient’s hospital stay after duodenal switch surgery can range from 2-5 days.
• Patients should expect to take 2-4 weeks off work to recover after duodenal switch surgery.

After Duodenal Switch Surgery

After duodenal switch surgery, you can continue to lose weight or maintain weight loss by eating a healthy diet and exercising regularly. You will also need to regularly follow up with your doctor for guidance on your diet and exercise plan and can attend our free support groups before or after surgery.

It is recommended that patients take the following measures to support their health after duodenal switch surgery:

• Eat a healthy diet, and take the right vitamins and minerals.
• Work with your dietician to create a healthy eating plan.
• Continue your follow-up diet, exercise and behavioral program.

Learn more about recovery and the post-surgery journey.

Pros and Cons of Duodenal Switch Surgery

Duodenal switch surgery has several advantages to help you lose weight and stay healthy. The pros include:

• Most helpful for patients who have a very high body mass index (BMI) and severe or multiple health risks
• The ability to eat larger meals than with other, purely restrictive procedures, which means a greater feeling of satisfaction
• Can lose up to 70 percent excess weight

While duodenal switch surgery can be right for you, it also comes with some things to consider:

• Your diet will need to change significantly for the rest of your life.
• You may experience nausea, vomiting and discomfort from food that you could once eat without a problem.
• Sugars and sweets can trigger dumping syndrome, which includes symptoms of nausea, weakness, sweating, anxiety and heart palpitations after eating. While these are not usually health risks, they can be uncomfortable or painful.
• Bypassing a large part of your intestine limits your body’s absorption of important nutrients, vitamins and minerals, such as protein, fat-soluble vitamins (A, E, D and K), iron, calcium, vitamin B-12 and folic acid. Daily supplements will need to be taken.
• Overeating can stretch the stomach pouch.

When it comes to duodenal switch surgery, patients should work closely with their doctor to monitor for protein malnutrition, anemia and bone disease.

It is important to note that smokers are not candidates for duodenal switch surgery as smoking puts patients at an increased risk for infections, blood clots, slow healing and other life-threatening complications.

Learn more about recovery and the post-surgery journey.

Risks of Duodenal Switch Surgery

As with any surgery, there are certain risks involved with duodenal switch surgery, such as:

• Risks with anesthesia or surgery, including bleeding, blood clots or death
• Duodenal switch surgery puts patients at a higher-than-normal risk of developing gallstones and gallbladder disease
• As intestines adjust, bowel movements can be liquid and less frequent; This condition may lessen over time but may be a lifelong condition
• Abdominal bloating and foul-smelling stool or gas
• Increased possibility of intestinal irritation and ulcers

Talk to your doctor to decide if duodenal switch surgery is right for you. Our bariatric team is here to help you through your weight loss journey.