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, which is performed through an open traditional incision, 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 flushed 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.

Advantages of Duodenal Switch

• Superior weight loss results, comparable to Roux-en-Y.
• Minimal gastric restriction, so larger meals are possible.
• 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 or reversal.