Duodenal Switch Surgery Advantages and Requirements

The duodenal switch reduces the stomach size, similar to the sleeve gastrectomy and bypasses much of the small intestine.

“Duodenal switch surgery combines a gastrectomy (removal of part of your stomach) with an intestinal bypass,” says Dr. Smith. This procedure works by reducing the amount of food your stomach can hold and decreasing the absorption of fats and proteins, requiring long-term adherence to vitamins and supplements. “It also changes how your gastrointestinal (GI) tract produces gut hormones, which help control hunger and dramatically affect illnesses such as diabetes and lipid disease.”

According to the NIH criteria, a person should have a BMI of 35 or higher with weight-related co-morbidities or a BMI of 40 or more to qualify for bariatric surgery. Some procedures, like duodenal switch surgery, work better for certain subsets of those patients. The more weight you have to lose, the more you may benefit from the duodenal switch.

“If you have a BMI of 50 or higher, your health care provider may recommend duodenal switch surgery to help you reach a healthy weight,” says Dr. Smith.

The duodenal switch is the most powerful operation we have for the treatment of diabetes and lipid diseases, like high cholesterol and high triglycerides.

Duodenal switch surgery has the highest success rate for weight loss and minimizing weight regain in the future. “The average weight loss with the duodenal switch is about 40% of a person’s total body weight over two years,” says Dr. Smith. In addition to weight loss, more than 90% of people with Type 2 diabetes can discontinue their diabetes medications after surgery.

“Duodenal switch surgery has the highest success rate of all bariatric surgeries with the greatest overall weight loss,” says Dr. Smith. Other advantages include:

• Covered by Medicare and many insurances
• Provides the best resistance to weight regain
• Highest percentage of weight loss of all bariatric operations
• Greatest effectiveness for diabetes, cholesterol and triglyceride problems
• Same length of hospital stay and activity restrictions as sleeve and Roux-en-Y Gastric Bypass surgeries

Just as with any procedure, there are some risks and disadvantages to the duodenal switch surgery. Some of them include:

• Greatest degree of long-term vitamin, nutrient and protein challenges
• Longer operating time
• More pre-op and post-op lab work is required than with the RNY or the sleeve gastrectomy
• Possible loose stools and foul-smelling gas
• Requires more vitamins and supplements than Roux-en-Y Gastric Bypass or sleeve procedures
• The most expensive if you have to self-pay

“For people with more weight to lose and more severe illnesses caused by obesity, the benefits of duodenal switch surgery outweigh the risks and can be lifesaving,” says Dr. Smith.