Duodenal Switch in Birmingham, AL

What is a Duodenal Switch?

A duodenal switch is a weight-loss surgery that modifies your stomach and your small intestine. It combines the removal of part of your stomach (sleeve gastrectomy) with an intestinal bypass, which makes the path your food takes through your intestines shorter.

Biliopancreatic Diversion with Duodenal Switch and Sleeve Gastrectomy

BPD/DS-S, often called Duodenal Switch, involves both restrictive and malabsorptive techniques.  It is similar to gastric bypass but with a more aggressive malabsorptive component. The proper candidate has a BMI over 50 and typically also has comorbid conditions such as type 2 diabetes mellitus. Dr. Cameron Askew is a board-certified general surgeon highly trained in performing biliopancreatic diversion with Duodenal Switch and sleeve gastrectomy to help patients with weight loss. If you are interested in learning more about your weight loss surgery options, call (205) 874-9780 to request an appointment at our general surgery clinic in Birmingham.

The procedure is done in these steps:

Restrictive step – This portion of the surgery involves removing a large portion of the stomach along with the greater curvature of the stomach similar to a sleeve gastrectomy.

Malabsorptive step – This is the unique part of the duodenal switch. The goal is to reroute a large portion of the small intestine, to create two separate intestinal paths with one common channel. The shorter path routes food to the common channel, while the longer path carries bile and digestive juices to the common channel. This way the food and bile mix before entering the large intestine. This reduces the time the body has to get calories from food being processed and as a result, patients may absorb only a position of the food they intake.

How Effective is a Duodenal Switch?

The duodenal switch is designed to treat people with severe obesity. It is the most complicated but also the most effective bariatric surgery. It’s especially effective against Type 2 diabetes.

The duodenal switch procedure restricts how much food your stomach can hold and how much nutrition is absorbed from your food by your small intestine. It also reduces your hunger hormones. A duodenal switch has been shown to help people lose more weigh than either a gastric sleeve or gastric bypass. It can also reduce the risk or other obesity related conditions including heart disease and hypertension.

Advantages of the Duodenal Switch

• Higher weight loss and higher sustainability of weight loss
• Compared to gastric bypass surgery, patients experience a reduced likelihood of issues such as unstable blood sugar fluctuations, dumping syndrome, marginal ulcers, food restrictions and intolerance.
• Corrects bile reflux (but does not treat acid reflux)
• Can be performed on patients who have undergone sleeve gastrectomy but experienced insufficient weight loss or a relapse with weight regain.

Disadvantages of Duodenal Switch

• Increase stool frequency and looser stools. Most patients have 4-5 bowel movements per day
• Foul gas-improved by chronic probiotic intake
• Does not directly treat acid reflux
• Longer anesthesia time with surgery around 1.5 – 2.5 hours
• 2 night hospital stay rather than 1 night.
• Higher vitamin requirement than gastric bypass or sleeve gastrectomy due to malabsorption

Am I a Candidate for a Duodenal Switch?

If you are interested in the duodenal switch, you can talk to Dr. Askew about the best option for weight loss.

This procedure is designed for those who are severely obese and you are at risk for experiencing obesity-related disease and illness. This can range from a BMI of 35-50, depending on your related conditions.

The duodenal switch is less commonly performed than other bariatric surgeries because it is more complicated and more extreme. It involves more cutting and stitching and takes out more of your gastrointestinal tract than other procedures do.

How is the Duodenal Switch Performed?

You will consult with Dr. Askew and review your medical history. You will be put under general anesthesia and the operation can take a couple hours.

During the procedure, the surgeon will remove part of your stomach and reroute the intestines. The name duodenal switch comes from the fact that in this operation the intestinal bypass starts at the duodenum. The first part of the intestine, the duodenum, is divided and attached to the lower portion of the small intestine, the ileum.

In some extremely overweight patients this operation is performed in two stages. First, the sleeve gastrectomy is performed followed 9-12 months later by the intestinal bypass portion of the procedure.

Talk to Dr. Askew about the specific methods and techniques that would work best for you.

Can I Have this done if I have had a Procedure Before?

Yes, this surgery may also be used as a revision operation for sleeve patients who have not lost enough weight or who regain significant weight.