On this page, you will learn more about biliopancreatic diversion with duodenal switch surgery; what it is, and how it works. You will also learn about potential complications and benefits of this type offers you for weight loss.
Most commonly referred to as the duodenal switch, this procedure is performed less commonly. It is better suited for patients with a high BMI with multiple medical problems, or who have gained weight after previous bariatric surgery.
Our NYC and NJ duodenal switch procedure is done robotically through several small incisions. This procedure is performed in one stage or two stages depending on patient circumstances. Duodenal switch has restrictive and malabsorptive components that work simultaneously to help you lose significant weight. This rapid weight loss helps with the resolution of many of the diseases that come about due to morbid obesity: diabetes mellitus, high cholesterol, and high blood pressure.
The first portion of the procedure involves creating a sleeve just as is done in the sleeve gastrectomy. We remove 70-80% of your stomach. The portion of the stomach that is removed is the area that makes a hormone called Ghrelin. Ghrelin is the hormone that stimulates feelings of hunger. The surgery also reduces the volume of your stomach, making you feel full more rapidly.
The second portion of the procedure involves rerouting the small intestine. This portion of the procedure is the malabsorptive part. Unlike in gastric bypass, this rerouting connects the last part of the small intestine to the first part of the small intestine just off the stomach. Rerouting or bypassing the small intestine means that small intestine is not removed, but changed in position- this change means you absorb less of the food you eat.
The average length of the small intestine in an adult is 20 ft or 610 cm. In the duodenal switch, you are only going to absorb your food normally in the last 100 cm of the small intestine. With less small intestine to absorb food, you absorb fewer calories but are at higher risk of malnutrition, dehydration, and problems due to insufficient absorption of vitamins and minerals.
All forms of gastric and intestinal surgery carry risk, and this procedure does carry a slightly higher risk. Patients selected to undergo duodenal switch are carefully selected and prepared.
The restrictive component of this operation (sleeve gastrectomy) significantly reduces your Ghrelin levels so your feelings of hunger will decrease after the operation. Restriction also decreases the volume of the stomach so you will also feel full faster and will not be hungry eating less food.
The malabsorptive component of this operation allows fewer calories to be absorbed - as a result, higher and more sustained weight loss occurs. Malabsorption improves your pattern of insulin secretion which results in a 95% reduction of type 2 diabetes. Malabsorption produces a significant decrease in LDL cholesterol (the bad cholesterol).
The sleeve component of the operation is irreversible due to the removal of 70-80% of the stomach.
Anytime we staple to remove part of your GI tract or create new connections, there is always a risk associated with the operation. We will review these risks in detail with you when we meet with you in the office.
The malabsorptive component of this operation does carry potential additional risks. It is important that you are committed to sustaining your fluid, protein and vitamin intake to avoid the risks of malnutrition and dehydration after this operation.
We are happy to go over the risks and benefits of our New Jersey and New York duodenal switch procedure with you, so you can ask any questions you have and ultimately feel confident about your weight loss procedure decision. Most insurances will cover the switch procedure. Our insurance experts will verify your benefits for you free of charge. If you do not have insurance coverage we can explain financing options for you.
Thanks to the combination of our expertise, cutting-edge technology, and unparalleled skills, we have achieved successful duodenal switch results time and time again, and we can deliver these same results to you. Duodenal switch surgery is just one of many options you have for bariatric surgical procedures. Contact the New York Bariatric Group at 800-633-8446 to learn more.
Those who are considering undergoing weight loss surgery have many questions and concerns. We have offered some basic information about the duodenal switch, and answers to some of the most common questions patients we are asked about the procedure.
The duodenal switch and gastric bypass both have restrictive and malabsorptive components in which a new connection between the stomach and small intestine is surgically created. The duodenal switch has a higher level of malabsorption. This malabsorption leads to a higher level of weight loss (85% of excess weight loss) and better sustainability of the weight loss. This procedure is ideal for patients with and high BMI and other medical issues related to obesity.
Research has shown that patients undergoing this surgery lose about 85 percent of their excess weight, on average. Additional weight can be lost if you carefully watch your diet and engage in a regular exercise program.
You will have lost a significant quantity of weight, very quickly, and will then “plateau.” Making it through this period is one of the most critical points in maintaining weight loss. You may want to add more exercise to your weight loss regimen to continue to lose weight. What you consume makes a difference – it is advised that you track what you consume and avoid sugary, fatty foods as a lifestyle change. One of the challenges you may face is not falling back into unhealthy eating habits.
Most patients are reported to lose about 85 percent of the excess weight. Even with such a dramatic loss of weight, many people want to lose even more, which can be accomplished without much difficulty by following a strict exercise and diet plan.
Most patients can return home the day following surgery. The most important issue in being released to go home is the ability to stay hydrated. You will be able to walk just a few hours after surgery and will start the first stage of the recovery diet with clear liquids. Any pain can be managed with prescription medication during this phase. Initially, you will feel very tired and will want to rest. Depending upon your general health, you will be ready to go back to work within one to three weeks for most patients.
If your body mass index, BMI, is greater than 50 and you have diabetes mellitus you are a strong candidate for the duodenal switch. You do need to be committed to keeping up with the daily protein requirement which can be done with food and protein shakes. You must take additional bariatric vitamins and supplements outside of a multivitamin for the rest of your life.
Our team is happy to speak with you and help you understand any of the treatments we offer, or answer any questions you have. Please call and speak with us at 800-633-8446, or read more about the surgical and non-surgical options we offer here.
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Learn more“The staff and doctors at the New York Bariatric Group are amazing! They are always patient, helpful, and very understanding and pro-active with questions, problems, etc. After Lap Band surgery I feel fantastic. For the last 6 years I have not had to worry if my clothes would fit. I have been able to maintain my weight loss, and have so much more energy.”
Learn more"Dr. Holover has a great personality, I love him, I consider him a good friend, and I recommend him to everyone. He and his staff are amazing. I thought my recovery would be worse, but it wasn’t. It was great. After a couple of days I was back on my feet and going, with three boys you don’t have time to be down. Now, my kids have to keep up with me!"
Learn more"My results are incredible; I can go to any store and find clothes that fit, I don’t have to go to the big and tall store anymore. My family and friends say I look great, but more so are so happy about my health. Definitely go for it, it is well worth it."
Learn more"My recovery was very easy, I started moving around pretty quick because the nurses had me up and about. Dr. Angstadt has a great bedside manner, a cheerful disposition and is very knowledgeable. He was genuinely concerned for me, he answered all of my questions and put me at ease. I couldn’t be happier, I think it is the best decision I ever made."
Learn more"I was concerned about my health, my blood pressure, cholesterol, my mobility, my flexibility. A few friends told me about NYBG and I went to a seminar. I wanted to live a healthier life and live a long life. My recovery was great, after a week I was 100%. My doctor, Dr. Sekhar, has the best personality in the world."
Learn more"I had a couple of friends who had bariatric surgery done by Dr. Garber a few years back and I decided to make the appointment. My favorite thing about the surgery is not being able to eat that much, eating whatever I want but in smaller portions. My results are amazing"
*Individual results may vary.
New and existing patients can call our offices at 1-800-633-8446 for assistance.
We are still offering VIRTUAL CONSULTATIONS and would be happy to speak with you. We are able to offer our patients all virtual visits via telehealth up until pre-surgical testing if requested.
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