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Advantages: Duodenal Switch (DS)

Although the duodenal switch is one of the most complex bariatric procedures, its benefits make the procedure a worth while one.

The duodenal switch leaves a larger portion of the stomach intact, including the pyloric valve that regulates the release of stomach contents into the small intestine. It also keeps a small part of the duodenum in the digestive pathway.

These operations often result in a high degree of patient satisfaction because patients are able to eat larger meals than with a purely restrictive or standard Roux-en-Y gastric bypass procedure. These procedures can produce the greatest excess weight loss because they provide the highest levels of malabsorption.

In one study of 125 patients, excess weight loss of 74 percent at one year, 78 percent at two years, 81 percent at three years, 84 percent at four years, and 91 percent at five years was achieved. Long-term maintenance of excess body weight loss can be successful if the patient adapts and adheres to a straightforward dietary, supplement, exercise and behavioral regimen.

This procedure has been done in thousands of patients - especially in Canada and Europe. Immediately following surgery, you will only be able to have small portions of food. You may even have to remind yourself to eat because you will not have much of an appetite - especially initially. Many patients’ taste for foods completely changes. You will have to re-learn what foods taste good to you and which ones do not upset your stomach.

Patients with a duodenal switch generally have less difficulty than patients with a RNY gastric bypass. This is because their stomach is bigger and there is no dumping syndrome. However, after a duodenal switch, fat absorption is difficult.

One of the major advantages, is that the duodenal switch can be performed laparoscopically (via video). In this instance, fewer incisions are made in the patient and as a result, less time spent in the hospital recovery is required. The benefits of laparoscopy have been proven to include less wound infections, fewer incisional hernias, less pain, quicker time to return to work, improved quality of life, less complications. Some previous operations make a laparoscopic technique challenging. As well, sometimes patients are too big to perform the procedure laparoscopically.

Another major benefit with the duodenal switch procedure is that it could fall under your insurance claim. Increasingly, insurance companies are beginning to recognize that obesity surgery is much more than a ”cosmetic” procedure, and they are covering it more now than ever.

Other advantages to the duodenal switch include:

  • More "normal" absorption of many nutrients than with BPD, including calcium, iron and vitamin B12
  • Better eating quality when compared to other WLS procedures
  • Eliminates or greatly minimizes most negative side effects of the original BPD
  • Essentially eliminates stomach ulcer and dumping syndrome