DS - DUODENAL SWITCH GASTRIC BYPASS
What is Duodenal Switch
DS is particularly effective for morbid obesity, offering superior long-term weight loss compared to other conventional methods. It also has a notable advantage in improving or resolving obesity-related comorbidities such as diabetes.
Duodenal Switch - How does it Work?
An advanced bariatric procedure performed under general anaesthesia, typically completed within 2-3 hours. through laparoscopic techniques.
A portion of the stomach is surgically removed, leaving a smaller, tubular stomach pouch. This reduction limits the amount of food that can be consumed at one time, contributing to weight loss by enforcing a lower calorie intake
Usually for BMIs over 60, with up to 80% excess weight reduction
A
Pre Procedure
Laparoscopic duodenal switch is recommended for individuals who meet certain criteria. These may include:
- Body Mass Index (BMI) of 60 or higher, indicating Morbidly obesity (class III)
- BMI of 40 or higher, accompanied by obesity-related health conditions such as diabetes, high
blood pressure, sleep apnea, heart disease, cholesterol etc. - Previous unsuccessful attempts at weight loss through diet, exercise, and other non-surgical
methods - Past medical and surgical history may also affect eligibility, so it is important to come in for a consult beforehand.
MEDICAL – Obesity-related illnesses such as heart disease, stroke, type 2 diabetes, cholesterol,
infertility, sleep apneas, asthma and cancer; are reduced. It also helps in long-term control of
type 2 diabetes, and less dependence on medication — or the elimination of medication
altogether.
PHYSIOLOGICAL – You may also enjoy the elimination of back and joint pain, decreased
depression, improved breathing and increased energy.
PSYCHOLOGICAL – Dramatic improvements in your overall health and quality of life with
improved self-image, increased self-confidence and the satisfaction that comes from enjoying a
wider range of activities with friends and loved ones.
Results may vary dependent on lifestyle changes as well, we recommend an amalgamated
approach for best results and sustainability.
WEEKS BEFORE
- To determine the suitability & your body’s fitness for the surgery we will take you thorough medical, psychological, nutritional assessments and pre- counselling.
- The pre-surgery weight loss diet is essential because it is low in fat and carbohydrate content,helping reduce your glycogen levels and reduce your liver size so that the operation can be conducted.
- There should be no intake of caffeinated drinks (coffee and energy drinks) at least a week before your surgery date.
- Your dietary intake in the week leading up to the surgery should be light like vegetables and fruits.
- You’ll need to stop smoking, eating heavy unhealthy meals, stop taking aspirin, ibuprofen, and other blood-thinning medicines in the days before your surgery.
- You shouldn’t eat or drink anything after midnight before surgery.
B
How Is It Done & How Does It Work
For this, a large portion of the stomach is removed with a surgical stapling, leaving you a narrow tube, or sleeve, from the top to near the bottom of the stomach. With less stomach to fill, you will feel full more quickly and eat less food and fewer calories.
The surgeon will make a cut in between the stomach exit and the duodenum and connect the stomach to a lower part of the intestines.
The remnant duodenum will then be rerouted and connected further down also to the intestines.
As a result, food will travel down the 1st tube stomach-intestine path, and the digestive juices
from the liver/pancreas will travel down the 2 nd remnant duodenal-intestine path.
The food and digestive juices will meet up again approximately 75% further down the intestinal pathway where the 2 parts conjoin.
This results in significant reduced food absorption and hence fewer calories
Between the stomach, pancreas, brain, and liver, it assists in establishing a lower and healthier body fat.
It causes changes in the normal way that bile and digestive juices break down food. This cuts back on how many calories you absorb, causing still more weight loss.
C
Procedure
Recovery may vary from person to person, but here’s what you need to know: Hospital Stay: 3-5 days after the surgery to ensure proper healing, rehabilitation and monitoring of progress. Patients who have undergone laparoscopic procedures may return to work within 1 week after surgery. However, it is not advisable to engage in intense physical work
Shortly after surgery, you’ll begin reintroducing foods into your diet in phases in consult with your nutritionist who will teach you how and what to eat with your reduced stomach size. You’ll start consuming a clear liquid diet within 24 hours of your surgery, then advance to a full liquid diet, a soft food diet, and your regular diet in the weeks ahead. You will also have to reduce certain foods, such as simple sugars, including honey, white sugar, or syrups, to avoid dumping syndrome. You will be need to chew slowly and fully, and not to drink 30 minutes before or after you eat. While it may seem demanding, ignoring dietary recommendations may cause constipation, dehydration, diarrhea, or in extreme very rare cases, gastric acid leakage.
You will have follow-up visits with your bariatric surgery team to help you develop good eating and exercise habits that will change your lifestyle. Your initial weight-loss may occur quickly, so it’s important to get all of the nutrition and vitamins you need as you recover. To prevent nutritional problems after surgery, your doctor may advise on supplements like Vitamin B12 and iron.
Tell your doctor right away if you have any of the below:
- Fever
- Your wound becomes painful or hot to the touch or leaks fluid
- Coughing or trouble breathing
- Vomiting and diarrhea
- Pain in the abdomen, chest, shoulder, or legs
- Any other problems or symptoms
During weight-loss, you may have body aches, dry skin, mood changes, and temporary hair
thinning, and feel tired and cold among others. As your weight stabilizes, these problems should
go away. Weight loss continues for about a year, and then it will stabilize at your body’s
optimum BMI. It is important to incorporate lifestyle modification for sustainability and lifelong
results.
FAQs
Obesity surgeries are evaluated based on body mass index, previous surgeries, previous medical history, amount of weight loss desired as well as financial implication – are the variables that help determine this.
It is dependent on an individual’s body mass index (BMI) and the presence of any co-morbidities. You may qualify for surgery if you have a BMI of 40 or greater, or if your BMI is at least 35 with other obesity-related health problems e.g. diabetes, heart disease, hypertension, and sleep apnea.
Usually 1-4 days of stay in the hospital. Problems that may occur during the preoperative evaluation and postoperative recovery period may determine this period.
Communication with your team and following your doctor’s instructions can prevent majority of the complications. Some include – dumping syndrome, dehydration, and nutrient deficiencies but can be avoided if the correct diet is followed and supplements.
We will transition you from liquid diet to solid diet gradually. High carb, sugary fluids and generally junk meals are to be reduced or completely avoided for better results, minimal side effects and sustainability of weight loss
After leaving the hospital, heavy activities should be reduced. The patient should not lift heavy loads for about 6 weeks.
TESTIMONIALS
DUODENAL SWITCH VS GASTRIC BYPASS
The duodenal switch is best performed on patients with a BMI greater than 60.
Duodenal switch is reserved for the most severely obese patients who are suffering from serious related medical issues. As a combination of gastric bypass and gastric sleeve, it reduces food intake and nutrient absorption significantly.
In this light, it is important to keep in mind risks like gallstones, bowel habit changes, excessive loose skin, and malnutrition, which are more likely in the duodenal switch compared to the gastric
bypass.
Lifestyle changes after the duodenal switch such as eating habits should be adapted well to prevent side effects.
It has less likelihood of weight regain relapse & achieves more weight loss compared to other bariatric procedures