Duodenal Switch Surgery

The first part of your small intestine is called the duodenum. Duodenal switch weight loss surgery shortens the path food follows through the small intestine. This reduces the time your body has to absorb calories from the food you eat and helps you lose weight.

What Duodenal Switch Weight Loss Surgery Involves

Duodenal switch surgery at Banner Health may be done using open surgery or minimally invasive techniques. Before surgery, your surgeon must check the condition of your gastric sleeve as the surgery can only be done if your stomach sleeve and your stomach opening to the duodenum (called the pylorus) are healthy.

This surgery involves three steps:

  1. 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 to 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.

When the surgery is complete, food from the stomach will now move through about 10 feet of small intestine instead of 20 feet which will cut your calorie and nutrient absorption in half.

Duodenal Switch Surgery Pros, Cons & Risks

Learn about the advantages and disadvantages of having duodenal switch surgery, as well as the risks.

Duodenal switch surgery has several advantages to help you lose weight and stay healthy, including:

  • It is most helpful for patients who have a very high body mass index (BMI) and severe or multiple health risks
  • People are often satisfied with duodenal switch surgery because they can eat larger meals than with a purely restrictive procedure such as LAP-BAND® or standard Roux-en-Y gastric bypass procedure
  • Duodenal switch patients can lose the most weight (usually about 70 % of excess weight)

If duodenal switch surgery is right for you, you can maintain good health as long as you:

  • Eat a healthy diet and take the right vitamins and minerals
  • Work with our dietitian on a healthy eating plan
  • Continue your follow-up diet, exercise and behavioral program

Even if duodenal switch is right for you, the surgery comes with several disadvantages and limitations you should consider. You will have to eat differently for the rest of your life. Consider:

  • Foods that you eat now may cause discomfort, nausea or vomiting after your surgery.
  • If you eat sugars and sweets, you can trigger dumping syndrome. Symptoms can include nausea, weakness, sweating, anxiety and heart palpitations (strong, fast or irregular heartbeats) after eating. This is not usually a serious health risk, but it can be painful.
  • Bypassing a large part of your intestine limits your body’s absorption of important nutrients, vitamins and minerals: protein, fat-soluble vitamins A, E, D and K, iron, calcium, Vitamin B-12 and folic acid. You will need to take daily supplements for the rest of your life.
  • If you overeat, you can stretch your stomach pouch.
  • You and your doctor should monitor for protein malnutrition, anemia (a lack of healthy red blood cells) and bone disease throughout your life. You must take the prescribed vitamin supplements for the rest of your life. Research shows 25 % of patients who do not follow eating and vitamin supplement instructions closely develop problems that require treatment.

Additionally, smokers are not candidates for duodenal switch surgery. Smoking would put you at high risk for infection, blood clots, slow healing and other life-threatening complications.

Discuss other potential risks to duodenal switch with your doctor, including:

  • Anytime you have anesthesia or surgery, there is a risk of bleeding, blood clots, other complications or death.
  • Gastric surgery puts you at higher-than-normal risk of developing gallstones and gallbladder disease.
  • There is a period when the intestines adjust and bowel movements can be liquid and frequent. This condition may lessen over time but may be a lifelong condition.
  • You may have abdominal bloating and foul-smelling stool or gas.
  • Duodenal switch increases the possibility of intestinal irritation and ulcers.

After your Duodenal switch surgery at Banner Health, you can continue to lose or maintain your weight by eating a healthy diet and exercising regularly. You’ll also follow-up with your doctor at Banner Health Weight Loss Centers for guidance and can attend our free support groups both before and after your surgery.