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.

How Does Duodenal Switch Surgery Work?

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.

Biliopancreatic Diversion With Duodenal Switch

First Portion

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.

Second Portion

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 the 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.

SIPS Bariatric Surgery at New York Bariatric Group

Advantages Of The Duodenal Switch Surgery

The restrictive component of this operation (sleeve gastrectomy) significantly reduces your Ghrelin levels so your feelings of hunger will decrease after the operation. The 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).