What is the Duodenal Switch?
Duodenal switch, also known as biliopancreatic diversion with duodenal switch, or vertical gastrectomy, is an effective weight loss procedure.
This procedure provides long-term weight loss for those people who are severely obese.
The duodenal surgery limits the amount of food that a stomach can hold and several calories that can be easily absorbed by the body.
The procedure of Duodenal Switch
The duodenal switch procedure combines Malabsorptive and restrictive procedure components.
The purpose is to provide maximum and quick weight loss results that can be maintained for a long period.
Malabsorptive: The portions of the small intestine are re-routed in the malabsorptive component of the duodenal switch method.
This re-routing is done for creating two separate pathways through the duodenum into the lower part of the small intestine.
This method aims to decrease the number of calories that a body can absorb.
This is done by restricting the food and seeing how long it can mix with digestive juices before moving into the large intestine.
Restrictive: During the initial part of the duodenal surgery, there is a removal of the outer curvature of the stomach.
The rest remaining part of the stomach is shaped into a slim and long sleeve called vertical sleeve gastrectomy.
The vertical sleeve gastrectomy maintains the pyloric valve in its place that is not possible in other gastrectomies.
This is done for controlling the movement of the food into the small intestine that removes the risk of dumping syndrome in a patient.
This procedure also keeps away other complications of stoma closure and blockages.
Benefits of Duodenal Switch
Some of its benefits include the followings:
- There is an average weight loss of about 60-80% excess weight.
- Duodenal switch results in a higher level of patient satisfaction as these patients can eat more normal-sized meals as compared to other bariatric patients.
- This procedure helps in achieving long-lasting and significant weight loss because of the malabsorptive component of the procedure.
- Ghrelin (a hunger hormone) is significantly decreased as there is a removal of a large section of the stomach.
- Duodenal switch is a very effective weight-loss procedure for those patients who have a BMI (Body Mass Index) of 50 or more.
- Duodenal switch is ideal for those patients who did not receive any benefit from other types of bariatric surgery.
- Pyloric valve is kept intact to avoid any incidence of stomal ulcers and dumping syndrome, which can happen by gastric bypass surgery.
The Laparoscopic Sleeve Gastrectomy with Duodenal Switch
This procedure is also termed as biliopancreatic diversion with a duodenal switch that helps in a weight reduction of about 45-55% of excess body weight.
This range is much higher as compared to laparoscopic adjustable gastric banding procedures.
One of the advantages of sleeve gastrectomy is that it preserves Pyloric Valve which regulates the emptying of the stomach while preserving certain centimeters of the duodenum.
This procedure is performed laparoscopically, where a small stomach pouch of 120cc size is created with the help of stapling devices.
The remaining stomach part is also removed. In this procedure, the stomach is simply reduced, and the gastrointestinal tract is not changed.
This procedure effectively limits the food intake that provides for maximum weight loss.
A sleeve gastrectomy patient will now be able to eat a cup of food three times a day and will feel fuller and more satisfied after eating a small amount of food.
A patient will now be able to control his/her cravings and hunger.
Duodenal Switch Success Rate
A patient who undergoes duodenal switch surgery can expect to lose about 29-37% of excess weight in the first three months.
- About in 90% of the patients, the condition of sleep apnea has completely disappeared.
- There could be 51% weight loss in the first three months, 55% weight loss in 6 months, and 80-90% of weight loss at the end of the second year.
- The problem of hypertension in about 85% of people has completely disappeared.
- The problem of asthma in about 60% of people has completely disappeared.
- The duodenal switch also helps in resolving about 47% of arthritis issues.
- This procedure has received 97% success rate in resolving the problem of diabetes.
- 96% success rate is also achieved in resolving the problem of high cholesterol.