Duodenal Switch


The biliopancreatic diversion with duodenal switch (BPD/DS) is a well established weight loss surgical procedure that provides excellent weight loss and long term resolution of health conditions associated with obesity. This operation is usually, but not always, reserved for the extremely obese (with a BMI of greater than 50) because this surgery tends to produce greater amounts of weight loss compared to other weight loss procedure—patients could lose from 60-85% of excess body weight.

Aside from limiting the amount of food one can eat, some scientists also think that this helps reduce the chemicals produced by the stomach that trigger hunger and eating. Unlike the Roux-n-Y gastric bypass, the Duodenal Switch keeps the pyloric valve between the stomach and small intestine intact eliminating dumping syndrome, marginal ulcers, stoma closures and blockages. These are the possible side effects observed in patients who have had other gastric bypass procedures but not with the duodenal switch surgery.

Am I a candidate?

Bariatric surgery is not for the casual dieter and there are several requirements that you will need to meet in order to be considered. Let us guide you through this process in a simple fashion. First, we need to know your height and weight. This will allow us to Calculate your Body Mass Index. BMI is an indicator used globally to indicate a healthy weight. Learn more about Body Mass Index

Restrictive and Mal-Absorptive

The restrictive part of the Duodenal Switch is achieved via partial gastrectomy (removal of part of the stomach), which reduces the size of the stomach.

The mal-absorptive component of the duodenal switch procedure is achieved by rearranging the small intestine to separate the flow of food from the flow of digestive juices (bile and pancreatic juices). Reducing the amount of bile and pancreatic juices the food comes in contact with reduces the amount of food that is digested and decreases absorption of some calories and nutrients.

The duodenal bypass has a significant effect on reversing obesity. Further down the digestive tract, the separated portions of the small intestinal are rejoined; food and digestive juices begin to mix, and limited fat absorption, essential for good health, occurs.

While the duodenal switch produces the greatest degree of weight loss of the bariatric procedures in use today, it also carries some additional risks which should be carefully evaluated when selecting this procedure.

How the Duodenal Switch is Performed

The traditional or standard approach to the duodenal switch is shown in the animation video.

In recent years, a modification the the standard duodenal switch has emerged. This is the so called "loop DS" or "SIPS" procedure. The benefits of the procedure include

  • reduced vitamin and protein deficiency
  • reduced number of daily bowel movements

There is a suspicion that the total weight lost will not be as robust as the traditional DS. This procedure should still cause greater weight loss than with a gastric bypass or sleeve gastrectomy.

Who Should Consider this Procedure?

  • If you are a diabetic or have hypertension, the DS is the most effective surgical weight loss procedure for the treatment of diabetes and hypertension.
  • If you are determined to prevent weight regain, the duodenal switch has the best rate of maintaining the weight you lose and preventing regain.
  • If you have had a previous procedure (Lap band, gastric bypass or sleeve) and have regained weight, the duodenal switch is a procedure that will help you lose that weight - and keep it off.
  • If you want to lose a lot of weight (BMI >45), the DS is the procedure that can help you lose the most weight compared to other weight loss procedures.
  • You must commit to life long vitamin replacement and close monitoring by your weight loss surgeon.

Are you a candidate?  Start Here