Duodenal Switch

The Duodenal Switch (DS) procedure, also known as biliopancreatic diversion with duodenal switch (BPD-DS), is a weight loss surgery procedure that combines restrictive and malabsorptive aspects.

The restrictive portion of Duodenal Switch surgery involves removing approximately 70% of the stomach along the greater curvature, essentially creating a larger-size Sleeve Gastrectomy.

The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver and digestive enzymes from the pancreas to the common channel. The common channel is the portion of small intestine in which the contents of the digestive loop mix with the contents from the biliopancreatic loop before emptying into the large intestine.

The objective of this surgical reconfiguration is to reduce the amount of time the body has to capture calories from food in the small intestine and limit the absorption of fat by 70% or more. A modification to the standard Duodenal Switch has only one anastomosis and is referred to as the Single Anastomosis Duodenal-Ilial Bypass with Sleeve, or the “SADI-S.”

The DS is done in our practice by laparoscopic, or minimally invasive, surgery through a few small incisions using small instruments and a camera to guide the surgery, and typically requires a two-day hospital stay. Laparoscopic surgery allows for faster recovery, less post-operative pain and fewer wound complications, such as infections and hernias, than open surgery. The DS is currently indicated for patients with a Body Mass Index (BMI) of 35 or above and those with a BMI or 30-34.9 along with an obesity-related comorbidity. It is most frequently done, though, in patients with a BMI over 50. Please note: BMI criteria for this surgery may vary by insurance provider.

Patients are asked to follow-up with us regularly for the first two years and then annually for a review that includes physical examination, nutritional evaluation, labs and the latest information regarding their continuing care. Follow-up visits are extremely critical in order to optimize weight loss and prevent or detect issues or deficiencies.