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Duodenal Switch

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What Is the Duodenal Switch?

Duodenal Switch (DS) or (SADI) is a surgical weight loss procedure designed to limit food intake as well as encourage malabsorption of food by altering the digestive process. Medically referred to as biliopancreatic diversion with duodenal switch (BPD), or single anastomosis duodenal ileostomy, this procedure can be ideal for those with severe morbid obesity, defined as a body mass index (BMI) of 50 or higher, and/or individuals who struggle with weight-related diseases, such as high cholesterol or diabetes. Our experienced, board-certified Chicago bariatric surgeons, who are Fellows of the American Society for Metabolic and Bariatric Surgery perform this complex procedure utilizing a fully robotic technique as a two-part approach.

The duodenal switch, also known as biliopancreatic diversion with duodenal switch (BPD/DS), or (SADI), is a type of weight loss surgery that combines two surgical techniques: sleeve gastrectomy and intestinal bypass. This procedure is designed to help people with severe obesity lose a significant amount of weight and improve obesity-related health conditions. Here’s an overview of the duodenal switch:

Procedure Components

  1. Sleeve Gastrectomy:

    • A large portion of the stomach is removed, leaving a smaller, tube-shaped stomach (sleeve).
    • This limits the amount of food that can be eaten at one time and reduces the production of the hunger hormone ghrelin.
  2. Intestinal Bypass:

    • The small intestine is divided into two parts. One part (the biliopancreatic limb) carries bile from the liver, and the other part (the alimentary limb) carries food from the stomach.
    • These two limbs are connected to create a common channel where food and digestive juices mix before entering the large intestine.
    • This bypass reduces the length of the intestine that comes in contact with food, decreasing the absorption of calories and nutrients.

The first step removes a portion of the stomach to restrict the amount of food for consumption, followed by dividing and rerouting the path to the small intestine to enable reduced calorie absorption. Weight loss with DS has shown to provide the greatest loss of excess weight compared to other procedures and can be highly effective for long-term results, with some patients having lost up to 81% of excess weight.* This procedure also has a significantly reduced risk of weight regain following surgery in the long run.

What Does the Duodenal Switch Procedure Involve?

Our skilled surgeons perform the DS procedure fully robotically with the Da Vinci platform using tiny surgical instruments inserted through small incisions in the abdomen. This technique can be used to reduce the stomach size by removing about three-quarters of the stomach pouch through a Vertical Sleeve Gastrectomy. This restricts the amount of food that the stomach is able to store and, therefore, how much you are able to comfortably consume. The small intestine is also operated on to influence less calorie and nutrient absorption.

The duodenum, which is the first section of the small intestine, is divided and redirected to the new stomach pouch. As a result, pancreatic and bile drainage is bypassed, causing the digestive juices and food to reach each other farther down in the intestine, which ultimately limits your ability to absorb calories.

This combination of decreasing the stomach size and causing malabsorption of calories allows for the highest weight loss potential.


What Complications Are Associated with the Duodenal Switch?

Although DS can be very effective for long-term weight loss and health improvements, the procedure is complex and may involve slightly more risk, depending on the patient’s health history. General risks associated with bariatric surgeries may include wound infection, incisional hernia, internal bleeding, reactions to anesthesia, and traveling blood clots. More specifically, DS surgery has a greater potential to develop deficiencies in a number of vitamins and minerals (calcium, iron, zinc, vitamins A and D, and more), which can eventually lead to anemia, kidney stones, and osteoporosis due to malabsorption. Typically taking a 1-a-day bariatric vitamin is sufficient to avoid any vitamin deficiencies. Patients should also be aware of their increased protein requirements as insufficient amounts in severe cases may cause protein-energy malnutrition. Our surgeons and medical team work closely with patients to educate them about any possible risks and mitigate the potential for complications.

What Is the Recovery Time After Duodenal Switch Surgery?

Following the DS procedure, a one-night hospital stay is required to monitor the rerouted digestive system and ensure everything is functioning properly. Fortunately, the advanced nature of performing the surgery robotically usually leads to a shorter recovery time, with most patients returning to work and normal daily routines after about one to two weeks. More strenuous or unrestricted activities can usually resume one month post-surgery, around the same time as the follow-up appointment to review the healing and weight loss progress. It is imperative to attend all follow-up visits and observe post-operation instructions that include dietary and supplement guidelines for a safe and successful recovery.

Schedule a Consultation

To learn more about the duodenal switch procedure, or to schedule a consultation with one of our bariatric surgeons, please contact Suburban Surgical Care Specialists/Kane Center today.

Medical Reference for Duodenal Switch:

*Healthline: Is Duodenal Switch Surgery Safe and Effective for Long-Term Weight Loss?