The Duodenal Switch (DS) procedure, also known as Biliopancreatic Diversion with Duodenal Switch (BPD-DS) or Gastric Reduction Duodenal Switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect.
The restrictive portion of the surgery involves removing approximately 70% of the stomach along the greater curvature.
The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel. The common channel is the portion of small intestine, usually 75-150 centimeters long, in which the contents of the digestive path mix with the bile from the biliopancreatic loop before emptying into the large intestine. The objective of this arrangement is to reduce the amount of time the body has to capture calories from food in the small intestine and to selectively limit the absorption of fat. As a result, following surgery, these patients only absorb approximately 20% of the fat they intake.
The primary advantage of Duodenal Switch (DS) surgery is that its combination of moderate intake restriction with substantial calorie malabsorption results in a very high percentage of excess weight loss for obese individuals, with a very low risk of significant weight regain.
Type 2 diabetics have had a 98% “cure” almost immediately following surgery which is due to the metabolic effect from the intestine switch. The results are so favorable that some surgeons in Europe are performing the “switch” or intestinal surgery on non-obese patients for the benefits of curing the diabetes.
The following observations were reported on the resolution of obesity related comorbidities following the Duodenal Switch: type 2 diabetes 99%, hyperlipidemia 99%, sleep apnea 92%, and hypertension 83%..
Because the pyloric valve between the stomach and small intestine is preserved, people who have undergone the DS do not experience the dumping syndrome common with people who’ve undergone the Roux-en-Y gastric bypass surgery (RNY). Much of the production of the hunger hormone, ghrelin, is removed with the greater curvature of the stomach.
Diet following the DS is more normal and better tolerated than with other surgeries.
The malabsorptive component of the DS is fully reversible as no small intestine is actually removed, only re-routed.
What is a laparoscopic duodenal switch?
Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Gastric Bypass. The Biliopancreatic Diversion with Duodenal Switch – abbreviated as BPD/DS – is a procedure with two components. First, a smaller, tubular stomach pouch is created by removing a portion of the stomach, very similar to the sleeve gastrectomy.
How does a duodenal switch work?
How does duodenal switch surgery work? In normal digestion, food moves from the stomach to the small intestine. The beginning of the small intestine is called the duodenum. … With a smaller stomach to hold food and a shorter digestive process, duodenal switch surgery can result in significant weight loss.
What is the difference between duodenal switch and gastric bypass?
During a gastric bypass, a surgeon shrinks the size of the stomach by making its upper portion into a smaller pouch and connecting that directly to the small intestine. In comparison, a duodenal switch involves “bypassing” much of the small intestine, where nutrients are absorbed.