Duodenum Switch Surgery

The Duodenum Switch Surgery is a weight-loss procedure intended for people with severe obesity. The procedure combines an intestinal bypass with a sleeve gastrectomy. This is considered one of the most challenging but very successful bariatric procedures, especially for people suffering from Type 2 diabetes.

Preparation for the duodenal switch:

Before the procedure, the patient undergoes a screening procedure after the doctor determines that he/she is an ideal candidate for surgery. The screening will probably entail:

• Screening for alcohol, tobacco, and any form of drug. If the screening is positive for these, then therapy is recommended to help the patient quit if necessary
• The patient must prove that he/she made an effort to lose weight in other ways but was unsuccessful
• Standard medical examinations to ensure the patient’s readiness for surgery
• Enrolling in a bariatric surgery seminar to ensure that the patient is aware of all the details involved in the procedure

Duodenum Switch Procedure

At CMC we offer both minimally invasive Robotic and Laparoscopic surgery to perform duodenal switch surgery. These approaches are considered minimally invasive as they use “keyhole” incisions and narrow instruments to perform the surgery.

Steps in the Duodenal Switch Procedure

Duodenal switch is a two-phase procedure whereby sleeve gastrectomy is the first stage followed by intestinal bypass. Some patients choose to have a sleeve gastrectomy alone, but if he/she wants to combine it with a duodenal switch, the surgeon will only remove roughly 65% of the stomach. The intestinal bypass, which is the next stage, may be performed during the same procedure or at a later time. Depending on the patient’s condition, the surgeon can suggest having two distinct operations if they believe it would be safer for the patient.

The duodenal switch can be performed in two different ways:

1. The original (biliopancreatic diversion) duodenal switch
2. The modified (loop) duodenal switch

Both procedures, performed under general anesthesia, split the patient’s small intestine towards the top, in the duodenum to start the bypass. Then the surgeon bypasses the center by bringing a lower portion of the patient’s smaller intestine up to connect to the top. The duodenum and a lower section of the small intestine are then swapped.

The original duodenal switch skips roughly 80-90% of the patient’s small intestine. As a result, the small intestine can no longer absorb as much nutrition from an individual’s diet. This will lead to significant weight loss but also a high risk of malnutrition.

Possible Risks and Complications of Duodenal Switch Surgery

Some of the possible risks involved in a duodenal switch procedure include:

• Wound infection
• Excessive bleeding
• Reaction to anesthesia
• Blood clots
• Anatomic leaks
• Hernia
• Small bowel obstruction