Laparoscopic Duodenal Switch Surgery

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What is Duodenal Switch Surgery?

Biliopancreatic diversion with duodenal switch (BPD/DS) or commonly called laparoscopic duodenal switch is a surgical weight loss procedure that uses both restrictive and malabsorptive techniques to facilitate weight loss. This procedure is normally performed laparoscopically which gives it the well-known name laparoscopic duodenal switch or LDS.

The duodenal switch is two-part surgery in which a large portion of the stomach (about 75%) is removed making it smaller using the same technique as gastric sleeve surgery, and then the digestive system is rerouted by altering the small intestine.

This surgical combination results in significant weight loss for most patients because the smaller stomach size naturally limits portion control preventing the patient from overeating and the alterations to the small intestine prevent the body from absorbing all the calories from the food that is consumed.

Many times, duodenal switch bariatric surgery is performed as two separate surgeries with a few months in-between to reduce risks and prevent long surgical times.

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Why Consider Duodenal Switch Surgery?

Patients who have had gastric sleeve surgery and failed to lose the amount of weight they desired or have experienced weight regain can benefit from undergoing a bariatric revision. Converting gastric sleeve weight loss surgery to duodenal switch adds the malabsorptive technique to the restrictive technique stopping weight gain and prompting further weight loss.

Historically, BPD-DS surgery has yielded tremendous weight loss and many patients have experienced remission or elimination of many serious, and even life-threatening, weight-related medical conditions after duodenal switch weight loss surgery.

Losing weight through duodenal switch surgery can lower the risks of many serious conditions including:

  • Heart disease;
  • Stroke;
  • Low quality of life;
  • Type 2 diabetes;
  • Sleep apnea;
  • Depression & anxiety;
  • High blood pressure;
  • Joint issues or osteoarthritis;
  • Limited physical functioning and mobility;
  • Abnormal cholesterol levels;
  • Several types of cancer.

How Much Weight Can I Lose With Duodenal Switch Surgery?

Patients who have had duodenal switch surgery often lose between 65% and 80% of their excess body weight during the first 12 months.

The formula that determines how much excess weight an individual is carrying is calculated by subtracting their ideal weight or goal weight from their current weight.

Example:

A patient who currently weighs 325 pounds and whose goal weight is 150 pounds has 175 pounds of excess weight. If they were to lose 70% of their excess weight (approximately 122 pounds) they would reduce their current weight from 325 to about 202 pounds.

These patients can lose additional weight or maintain their weight loss by persevering with their healthy low-calorie diet, ongoing exercise plans, and continued behavior modification. Most patients will reach their goal weight after 24 months.

Illustration: How duodenal switch surgery

Who Is A Candidate For Duodenal Switch Surgery?

The basic criteria for duodenal switch surgery are:

A BMI (body mass index) of 40 or higher
A BMI of 35 or higher and suffering from serious weight-related health issues, such as uncontrolled diabetes (type 2)
Have had previous unsuccessful bariatric procedures

Patients who are considering duodenal switch surgery must be committed to making permanent changes in their lifestyle including diet and exercise. They must also be dedicated to the lifelong participation in follow-up care and utilization of support systems.

How Much Does Duodenal Switch Surgery Cost?

The average cost of duodenal switch surgery in the United States is between $21,000 and $29,000. Duodenal switch (DS) surgery may be covered by insurance so the amount paid by the patient may be offset. Additionally, the use of FAS or HSA, or other resources may help reduce patient out-of-pocket responsibility.

When comparing costs associated with the duodenal switch procedure, keep in mind that most quotes are not all-inclusive and many necessary fees are not included. For example, the fee for anesthesia, operating room or surgical facility fee, etc may not be included in the quote you receive. Also, it is important to understand that the skill, expertise, and extensive knowledge of the surgeon or healthcare specialist who is working with you or performing your surgery makes up a portion of the surgical costs.

IBI Healthcare Institute’s transparent pricing structure is all-inclusive and you will understand your financial obligation before the surgery so there are no unpleasant surprises. You can even get an estimate of the cost of surgery using our convenient pricing tool.

IBI Healthcare Institute offers financing options for qualified patients.

Take the first step on your journey to a healthy life

IBI Healthcare Institute provides an unmatched patient experience and outstanding results. You matter to us.

When Will I Start Seeing Results From Duodenal Switch Surgery?

Patients typically lose weight rapidly following duodenal switch surgery. Normally patients see the most dramatic loss of their excess weight in the first three months. Many patients report losses of between 40 and 90 pounds by 90 days post-op.

Weight loss speed may vary by patient depending on whether the surgery was completed in one surgical session or split into two procedures.

Duodenal surgery helps patients lose a tremendous amount of weight for the following reasons:

The reduction in stomach size forces portion control;
Limited calories can be absorbed during digestion due to the re-routing of the small intestines;
Eliminating a large portion of the stomach during duodenal switch surgery greatly reduces the production of the hormone ghrelin which is responsible for the hunger messages transmitted from the brain. Patients feel full longer and they are not constantly bothered by hunger pangs.

How Long Will The Results From Duodenal Switch Surgery Last?

Results of duodenal switch surgery are expected to last a lifetime provided that the patient continues to maintain their commitment to practice and implement the necessary lifestyle changes like diet and exercise.

The surgery is meant to be used as a tool to help the patient to achieve their weight loss goal but long-term success requires ongoing patient dedication.

Are There Any Risks Associated with Duodenal Switch Surgery?

Most duodenal switch side effects are mild and can be controlled or corrected however, duodenal switch, like any surgical procedure, has associated risks. Some possible risks include:

  • Excessive bleeding;
  • Negative reaction to general anesthesia;
  • Breathing or lung issues;
  • Infection;
  • Deep vein thrombosis or blood clots;
  • Gastrointestinal system leaks.

Some rare, but long-term, side effects of duodenal switch surgery include:

  • Obstruction of bowels;
  • Gallstones;
  • Malnutrition;
  • Perforation of the stomach ;
  • Hernias;
  • Ulcers;
  • Dumping syndrome – diarrhea, nausea, or vomiting;
  • Hypoglycemia or low blood sugar;
  • Vomiting.

Is Duodenal Switch Surgery reversible?

Duodenal switch surgery is considered permanent however a portion of the procedure may be reversed in certain cases.

Since the surgeon removes a portion of the stomach during the “gastric sleeve” portion of the surgery there is no way to reverse this. However, It is possible, in some cases, to reverse the alterations to the small intestine for patients who experience digestive issues after duodenal switch surgery.

How Do I Know If Duodenal Switch Surgery Is Right For Me?

Patients who suffer from severe obesity are normally good candidates for duodenal switch surgery. A consultation with your bariatric surgeon is an excellent way to learn more about different weight loss procedures and to determine if traditional duodenal switch surgery or the SADI-S technique may be the best option for you.

Traditional Duodenal Switch Surgery vs SADI-S

Traditional duodenal switch surgery alters two portions of the small intestine however, there is a modified duodenal switch (loop duodenal switch) or SADI-S that alters only one portion of the small intestine. The SADI-S technique has been found to reduce the chances of patient malnutrition which can be a long-term side effect of duodenal switch surgery.

How Long Is The Recovery From Duodenal Switch Weight Loss Surgery?

Duodenal switch recovery will vary for each patient and will depend on many factors including the technique used for the duodenal switch procedure, the general health of the patient, any complications that may arise, etc.

Overall, this is a more difficult surgery and takes longer to perform than most other bariatric weight-loss procedures which makes the duodenal switch recovery time significantly longer as well.

Many individuals experience pain for about a week to ten days which can be managed with pain medication that the surgeon will prescribe. The sites where the incisions were made may also be swollen and tender for about a week.

It is important to follow all of the aftercare directions provided by the surgeon to mitigate the risks of infection or other complications. These instructions will also detail any activity restrictions patients must adhere to as they recover to prevent any damage to the surgical sites.

Take the first step on your journey to a healthy life

IBI Healthcare Institute provides an unmatched patient experience and outstanding results. You matter to us.

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