What is Duodenal Switch?

Duodenal switch, also known as biliopancreatic diversion with duodenal switch, or vertical gastrectomy, is an effective weight loss procedure. This procedure provides long-term weight loss for those people who are severely obese. The duodenal surgery basically limits the amount of food that a stomach can hold and number of calories that can be easily absorbed by the body.

Candidates for Duodenal Switch

• Insulin-dependent diabetic or poorly controlled diabetic has the highest cure rate with duodenal switch.
• Candidates who have severe diabetes or has BMI (Body Mass Index) of 60 kg/m2

Procedure of Duodenal Switch

Malabsorptive and restrictive procedure components are combined by the duodenal switch procedure. The purpose is to provide maximum and quick weight loss results that can be maintained for a long period of time.

Malabsorptive: The portions of the small intestine are re-routed in the malabsorptive component of the duodenal switch method. This re-routing is done for creating 2 separate pathways through the duodenum into the lower part of the small intestine. The aim of this method is to decrease the quantity of calories that a body can absorb. This is done by restricting the food and seeing how long it can mix with digestive juices before moving into the large intestine.

Restrictive: During the initial part of the duodenal surgery, there is a removal of the outer curvature of the stomach. The rest remaining part of the stomach is shaped into a slim and long sleeve called as vertical sleeve gastrectomy. The vertical sleeve gastrectomy maintains the pyloric valve in its place that is not possible in other gastrectomies. This is done for controlling the movement of the food into the small intestine that removes the risk of dumping syndrome in a patient. This procedure also keeps away other complications of stoma closure and blockages.

Benefits of Duodenal Switch

Some of its benefits include -

• There is average weight loss of about 60-80% excess weight.
• Duodenal switch results in higher level of patient satisfaction as these patients are able to eat more normal sized meals as compared to other bariatric patients.
• This procedure helps in achieving long-lasting and significant weight loss because of malabsorptive component of the procedure.
• Ghrelin (a hunger hormone) is significantly decreased as there is a removal of a large section of the stomach.
• Duodenal switch is a very effective weight loss procedure for those patients who have a BMI (Body Mass Index) of 50 or more.
• Duodenal switch is ideal for those patients who did not received any benefit from other types of bariatric surgery.
• Pyloric valve is kept intact in order to avoid any incidence of stomal ulcers and dumping syndrome which can happen by gastric bypass surgery.

The Laparoscopic Sleeve Gastrectomy with Duodenal Switch

This procedure is also termed as biliopancreatic diversion with duodenal switch that helps in weight reduction of about 45-55% of excess body weight. This range is much higher as compared to laparoscopic adjustable gastric banding procedures. One of the advantages of sleeve gastrectomy is that it preserves Pyloric Valve which regulates the emptying of the stomach while preserving certain centimeters of the duodenum. This procedure is performed laparoscopically where a small stomach pouch of 120cc size is created with the help of stapling devices. The remaining stomach part is also removed. In this procedure the stomach is simply reduced and the gastrointestinal tract is not changed.

This procedure effectively limits the food intake that provides for maximum weight loss. A sleeve gastrectomy patient will now be able to eat a cup of food in three times a day and will feel more full and satisfied after eating small amount of food. A patient will now be able to control his/her cravings and hunger.

Cost of Duodenal Switch Surgery

India is considered as a healthcare hub for many international patients that offer cost-effective duodenal switch surgery. Low-cost surgeries along with latest medical facilities have attracted many national as well as international patients to India.

Duodenal Switch Success Rate

A patient who undergoes duodenal switch surgery can expect to lose about 29-37% of excess weight in the first three months.

• About in 90% of the patients, the condition of sleep apnea has completely disappeared.
• There could be 51% weight loss in first three months, 55% weight loss in 6 months and 80-90% of weight loss at the end of second year.
• The problem of hypertension in about 85% of people has completely disappeared.
• The problem of asthma in about 60% people has completely disappeared.
• Duodenal switch also helps in resolving about 47% of arthritis issues.
• This procedure has received 97% success rate in resolving the problem of diabetes.
• 96% success rate is also achieved in resolving the problem of high cholesterol.