What is Gastric Reduction Duodenal Switch?
A gastric reduction duodenal switch surgery is also known as a ‘duodenal switch’ (DS) procedure and ‘biliopancreatic diversion
with duodenal switch (BPD-DS).
This is a weight loss procedure that involves removing a major portion (around 70%) of the stomach to attain malabsorptive and restrictive aspects, this results in lesser absorption of food by the small intestine and hence, fewer calories. This surgery is considered as an ideal weight loss surgical procedure
for people who are super-obese (with a BMI of 50 and higher).
This is a last-resort for losing weight by extremely obese people who have failed to achieve the desired results through all other weight loss non-surgical and surgical procedures.
Am I a candidate for a Gastric Reduction Duodenal Switch surgical procedure?
You are considered as an ideal candidate for a gastric reduction duodenal switch surgery if you are super obese with a BMI of 50 or higher.
This is an effective weight loss procedure and is normally considered as a last resort for extremely obese people who have had other various non-surgical and surgical weight loss procedures but have had unsatisfactory results by them.
It is important to note that this is not a direct weight loss procedure rather it is an assistive weight loss method that helps you lose weight over a short period of time if you take all precautions and follow the doctor’s instructions diligently.
What is the Gastric Reduction Duodenal Switch surgery procedure?
The food you eat passes down the food pipe (esophagus) into the stomach and through it to the small intestine. The small intestine releases digestive juices to help break down the food and retrieve the nutrients from it. After the food gets digested the remaining waste is passed on to the larger intestine (colon) and excreted eventually from your body.
The gastric reduction duodenal switch surgery aims to basically decrease the size of the small intestine so that less amount of food gets converted into calories which eventually results in weight loss.
The procedure can be performed as a conventional open surgery or as a minimally invasive surgical procedure with the help of a laparoscope (thin, flexible surgical tube).
The main steps of this surgery involve:
- Removing a large part of the stomach in order to create a cylinder-shaped smaller pouch that connects the food pipe (esophagus) to the top of the small intestine.
- The upper portion of the small intestine is cut while a part of the duodenum is left attached to the stomach.
- A large portion from the lower part of the small intestine that connects it to the large intestine (colon) is removed and the remaining portion is reconnected to the duodenum.
- The remaining loose part of the small intestine is then reattached to the small intestine and this allows the digestive juices to mix in around 15%-20% of the remaining small intestine.
This results in lesser portion of the smaller intestine being active in absorbing nutrients from the food before passing it along to the large intestines (colon) this acts as a restrictive and mal-absorptive procedure.
What are the risks associated with Gastric Reduction Duodenal Switch surgery?
As with any other major surgery this surgery also carries certain risks, such as:
- Leakage (fluid from stomach can enter into abdominal cavity)
- Deep vein thrombosis (blood clot in leg)
- Pulmonary embolism (blood clot in lung)
- Dumping syndrome – Occurs when the food gets dumped too quickly into the small intestine. May cause sweating, weakness and nausea and possible diarrhea after eating.
- Malnutrition – Caused due to less absorption of nutrients from the food.
How effective is Gastric Reduction Duodenal Switch surgery?
Gastric reduction duodenal switch surgery is highly effective and results in you losing around 75%-80% of excess weight and maintain this lower weight as well. The long-term success of this procedure also depends on the diligence you show in following the post-surgical instructions of the doctor regarding changes in diet, life style and other precautions that are advised.