The duodenal switch procedure, also known as the “switch,” is a weight loss procedure that combines techniques from gastric bypass and sleeve gastrectomy.
The Duodenal Switch Procedure
During this procedure, a sleeve gastrectomy is performed first. Around 80% of the stomach is removed and the remainder is converted to a slender tube. Then, the small bowel that normally connects to the stomach (called the duodenum) is divided, to create a bypass.
Normally, the food you consume goes from the sleeve into the initial part of the small intestine. With this procedure, it is rerouted or “switched” to the lower part of the small intestine.
There are a few separate ways to go about the bypass portion of this procedure. A common technique is the single anastomosis switch. This is where a sizable portion of the small intestine is bypassed, and a single connection is created between the bottom of the sleeve and the small bowel.
How Duodenal Switch Works 
Since the stomach size is reduce, this procedure decreases caloric intake. It also reduces absorption and changes the hormonal balance in the GI tract.
This surgery leads to decrease in ghrelin (the hunger hormone), an increase in insulin sensitivity and a decrease in the body’s desire to store extra energy in the form of fat.
Additionally, it changes the types of bacteria that live in our GI tract, replacing the bad bacteria with good ones. This has been shown to improve weight loss and weight management.
Good Candidates for Duodenal Switch Surgery
On average, this procedure is best suited for patients with a BMI of 50 or above. Sometimes, this procedure may be performed in stages, with the sleeve being created first and the bypass portion following in 6-18 months.
With this procedure, patients can expect to lose between 70-100% of their excess body weight. Furthermore, long term success is amongst the highest seen with any bariatric surgery. Additional benefits include 95% resolution of diabetes, 68-75% resolution of high blood pressure and a 70-75% resolution of high cholesterol.
Duodenal Switch Surgeon in Maryland
If you are interested in learning more about this procedure and how it could help your weight loss journey, please contact Maryland Bariatrics today.
