Types of Bariatric Surgery

Duodenal Switch

Duodenal switch is an operation used by about four percent of bariatric surgeons worldwide. During a duodenal switch operation, much of the stomach is removed, making it tubular and smaller. This allows for a feeling of fullness and satisfaction with a restricted amount of food intake.

The small intestine is divided and rearranged so that the digestive enzymes travel though a separate segment of intestine and meet with the food in a short segment near the large intestine. This results in decreased absorption of calories from fats and carbohydrates, which are lost into the colon and out of the system. The exit valve (pylorus) of the stomach is not disrupted, therefore patients do not experience dumping syndrome (intolerance to sugars). However, a diet high in fat could lead to diarrhea.

At St. Luke’s Metabolic and Bariatric Center, a duodenal switch is typically performed laparoscopically, so the hospital stay is only two-three days and the patient is back to work within two weeks.

Advantages of Duodenal Switch

• Superior weight loss results
• Can produce 200-300 pound weight loss in the “super-super obese”

Disadvantages of Duodenal Switch

• Usually requires an incisional operation (not laparoscopic)
• Need for more supplements long-term because of deficiencies related to the malabsorption
• Can cause gaseousness and diarrhea if excess fats are ingested
• 3-5 percent will require revision

Patient Responsibility

Your success with a duodenal switch will depend greatly on your involvement in an exercise program and adherence to nutritional guidelines.