Duodenal Switch Procedure surgical weight loss

Duodenal Switch Procedure

This surgical option reduces the amount of food that the stomach can hold and decreases the amount of nutrients and calories that are digested and absorbed. The Duodenal Switch (DS) procedure removes most of the stomach, leaving a long narrow tube. This stomach pouch is approximately the diameter of your index finger and holds only about four tablespoons of food. The portion of the stomach that is detached is completely removed from the body.

After the pouch is formed, the first part of the small intestine is divided to separate the flow of food from the flow of the digestive juices. A second division of the small intestine is made about two thirds of the way down toward the colon. The far end of that division is brought up and attached to near end of the first bowel division, while the bowel that is being bypassed is reattached to the small intestine about 100 cm from the junction with the colon.

Food now passes from the mouth, through the stomach and into the new small intestinal pathway, bypassing about two thirds of the small intestine. The digestive juices flow down through the other bowel pathway, not being allowed to mix with food until the point 100 cm from the end of the small intestine where the two paths were rejoined. Once the food and digestive juices are allowed to mix, there’s only about 100 cm of small intestine left, and this is now the only part of the bowel in which fat can be absorbed. This arrangement also restricts the digestion and absorption of some complex carbs, some proteins, and some other nutrients, vitamins and minerals.

The Duodenal Switch is a very powerful operation with many advantages and disadvantages. It’s generally felt to be the most powerful operation for insulin-dependent diabetics, people with very high triglyceride or cholesterol levels, and/or people with a great deal of weight to lose (BMI >60 or so). The Duodenal Switch should be used with caution and in the right situation, and the patient should have a very good understanding of how they can keep themselves out of trouble, but for the right person it can be an extremely effective and rewarding operation.