It’s no secret that obesity is a known cause of bad cholesterol, high blood pressure, and increased risk of heart attack, stroke, type II diabetes, and increased risk of developing certain cancers. Because of this, many patients are looking for safe ways to lose weight with surgery.
This surgical procedure combines malabsorptive and restrictive techniques. The first portion of the surgery is a partial gastrectomy, where a portion of the stomach’s pouch is removed. This helps to reduce hormone secretion and also limits the stomach’s size. Both of these things have been shown to decrease hunger. This also alters the digestive process and helps to limit food absorption in the body. A patient will feel full quickly, limiting the number of calories consumed.
After completing the first step, the surgeon will reroute the intestinal tract, including small intestine changes. Unlike gastric bypass surgery, the duodenal switch doesn’t remove the entire pyloric valve. This helps eliminate several negative gastric bypass side effects, such as dumping syndrome.
The small intestine is altered to separate the flow of food, bile, and digestive liquids. This helps to eliminate many breakdowns and the absorption of food into the intestines. Ultimately, fewer calories and nutrients are absorbed in each meal.
Risk of Vitamin Deficiency
While this promotes weight loss, it also leads to some nutritional or vitamin deficiencies in other patients. Many patients lack calcium and iron, leading to osteoporosis or anemia. Other deficiencies can occur in Vitamins A, D, E, and K, which, if untreated, can affect the nervous system. Protein deficiency also occurs in 18% of patients. This makes follow-up visits and regular blood tests important for duodenal switch patients.
Weight Loss Success
With duodenal switch surgery, patients can expect to lose nearly 60-80% of their excess weight, most of which occurs during the first year. The success rate for maintaining this weight loss for 8 years after the surgery is 70%.
Benefits of the Surgery
Many deem this the most successful bariatric surgical procedure for those with extreme weight loss. This is because it requires no post-surgical adjustments like gastric banding and fewer diet restrictions than gastric bypass surgery.
Many patients have found they can reduce their use of medications for Type II Diabetes, high blood pressure, arthritis, sleep apnea, cardiovascular disease, or GERD following duodenal switch surgery.
Disadvantages of This Surgery
Many patients require lifelong dietary supplements because of the combination of malabsorption and restrictive techniques. The stomach also increases in size, which does not reverse. Gallstones are also common with this type of surgery, much like other bariatric surgery procedures.
Risks/Complications For Surgery
All surgeries have potential risks and complications. Discussing this with one’s surgeon before committing to the procedure is important. The biggest risk of this procedure comes with how food is absorbed, which could lead to nutritional deficiencies. Take regular nutritional supplements (approved by your doctor) and follow the dietary guidelines for the post-duodenal switch diet. Also, eat lots of fat and protein, which helps absorb more nutrients.
Other potential complications as a result of surgery are dumping syndrome (1-2% of patients experience this), ulcers, and blockage, all of which are very rare.
Candidates for Duodenal Switch Surgery
This powerful weight loss surgery requires that the patient does not have life-threatening diseases. Because of the high expected weight loss, many patients must be evaluated thoroughly to determine their safety during this procedure. Patients must have a BMI (body mass index) of 40 or more. For patients that are 35 or more in terms of BMI, they must have co-morbidities that make their risk of death from obesity high. These conditions include hypertension (high blood pressure), high cholesterol, type II diabetes, obstructive sleep apnea, and metabolic syndrome.
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