Duodenal Switch Procedure

This is a procedure that is generally only considered for the super morbidly obese. It is a very extreme, irreversible operation and the implications of having this procedure should be considered very, very carefully before allowing a surgeon to do this to you.

This operation is sometimes performed in two stages, involving 2 general anaesthetics, depending on the BMI of the patient. Because surgery for the super morbidly obese patient is very risky, sometimes the surgeon opts to perform the gastric sleeve operation first, to allow the patient to lose some weight and reduce their BMI to a safer level, before continuing to the Malabsorption operation. The stomach is dissected to leave a 'tube' of stomach which will restrict the volume of food that can be eaten. The procedure leaves the pyloric sphincter, at the bottom of the stomach,  intact so there is no complications such as dumping syndrome like there is with the RNY. Because the larger part of the stomach has been physically removed, this is why it is impossible to reverse this operation.

The bowel is then cut just after the duodenum ( which would be bypassed by the RNY procedure), and is re-plumbed to give a very short absorptive section of bowel. About 90% of the small intestine is bypassed which restricts the intake of calories and fats from what is consumed, and aids weight loss and maintenance of a healthy weight once a BMI of 25 has been reached. 

Similar results to the RNY can be achieved with this operation, but it really is a far more risky procedure because the stomach is actually removed from the body.

Pros

 Diabetes improves - 9/10 patients with diabetes find they are better able to control their blood sugars, or are cured of diabetes altogether.

Blood pressure lowers - 9/10 patients with high blood pressure also see a radical improvement in their BP readings.

Breathing at night eases - 8/10 patients wit sleep apnoea ( breathing problems when sleeping) see a cure, or an improvement at the very least.

Fast weight loss - The operation carries the quickest weight loss, and most do not have any regain in weight even years down the line,

No diet clubs ! - Better option than to join diet clubs, take diet pills, or try to cut down on food intake, for the super morbidly obese, because weight loss is dramatic and sustainable.

Cons

Irreversible A large part of stomach is removed and therefore the operation is irreversible

Complications - This operation carries a high risk of post operative complications such as leaks.

Flatulence - Patients frequently suffer from extremely malodorous flatulence, and pass frequent bowel movements.

Obstruction risk - There is a permanent risk of bowel obstruction

Nutrition deprivation - Severe nutritional deprivation can lead to some very dangerous medical conditions. Daily vitamins, and a high protein diet are essential.

Hair loss - Hair loss is common

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