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What is a 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 result in more significant weight loss compared to other weight loss procedures.
Some of our patients lose anywhere from 60-85% of excess body weight.

Aside from limiting the amount of food one can eat, some scientists also believe 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.

Duodenal Switch is 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 food comes in contact with reduces the amount of food that is digested, thereby decreasing absorption of some calories and nutrients.

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 food comes in contact with reduces the amount of food that is digested, thereby decreasing absorption of some calories and nutrients.

How Does the Duodenal Switch Work?

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

In recent years, a modification to the standard duodenal switch has emerged, commonly referred to as the "loop DS" or "SIPS" procedure.

The benefits of this modified procedure include:

01 Reduced vitamin and protein deficiency

02 Reduced number of daily bowel movements

Who is a Good Candidate for the Duodenal Switch?

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

Are you a candidate?

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Duodenal Switch Program Assessment Videos

Please watch the videos below before completing your pre-operative quiz.

Duodenal Switch Program Assessment Quiz

Please bring the completed form to your pre-op appointment.

Pre-Op Quiz