Duodenal Switch

I would like to share my personal post-op experiences, fact based knowledge and background regarding my surgery which is a combination of the Vertical Sleeve Gastrectomy (VSG) and Duodenal Switch (DS), performed under 1 surgical procedure. It is medically known as a a gastric restriction with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy to limit absorption. It is known by its formality as a bilio-pancreatic diversion with duodenal switch and abbreviated as BPD/DS or DS. A not so wordy way to say it is sleeve gastrectomy with duodenal switch or just the DS.

I had my laparoscopic duodenal switch procedure on Nov 14th, 2006 for the surgical medical treatment of morbid obesity that can kill you. I am still the same person within, only my outer shell has morph to what I once looked like before this disease imprisoned me. The most important thing that matters is, I have my health back and that means more to me than the actual weight loss.

What is your body if you are not healthy with your respiratory, circulatory, cardiac and digestive system working properly and have mobility to be able to do things on your own, independently with no limitations, no complications or becoming a fatality?

This is what bariatric surgery outcome has done for me, give me my health as well as my life back!

The Duodenal Switch (DS)

The DS procedure has been performed since 1988 and combines restrictive and malabsorptive elements to help achieve and maintain long-term weight loss:

1. by restricting the amount of food that can be eaten through a reduction in stomach size

2. limit the amount of food that is absorbed into the body through a rerouting of the intestines

3. have a metabolic effect induced by manipulating intestinal hormones as a result of intestinal rerouting

The overall effect is that DS patients are able to engage in fairly normal, free eating, while having the benefit of taking on the metabolism of a lean individual.

Tuesday, April 8, 2008

What is the surgery I had all about?

The Duodenal Switch, although a bariatric surgical procedure for weight loss, is NOT a gastric bypass.

This type of method keeps a portion of the duodenum in the food stream. The preservation of the pylorus means that food is digested normally in the stomach before being excreted into the small intestine. The outer curvature of the stomach pouch is removed known as partial gastrectomy that restricts food to be consumed as well as limit the amount of food intake, especially fat to be absorbed into the body which is caused by the intestinal switch. This effectively restricts its capacity while maintaining its normal functionality. The BPD-DS procedure keeps the pyloric valve intact in which helps eliminate the possiblity of dumping syndrome, ulcers as well as stoma closures and blockage known as strictures. The intestinal tract is divided into 2 limb sections (the food limb and the biliopancreatic limb) that are reconnected and meet together to what is known as the common channel (the end limb portion of the small intestinal tract) and moves on to the large intestine. The food limb is also known as the alimentary limb, where the food is digested. The biliopancreatic limb basically processes the digestive juices. When both meet at the common channel at the bottom of the small intestines, the food and digestive juices mixes together and moves further on to the rest of the digestive tract system.

In plain English, with the BPD-DS, you have 2 intestinal tracts, one tract is to digest the food and the other tract is to digest the gastric juices in which both tracts known as limbs meet together again at the end of the small intestines. This is what a Duodenal Switch function is primarily about and explained in the simplest and generic form without getting in depth, if the above synopsis is too technical to comprehend.

The advantages of having the Duodenal Switch procedure are:



You have a more normal stomach that allows for better eating quality


You can drink with meals


There are no dumping syndrome since the pylorus is not removed


There is a minimal risk of having ulcers


There are no strictures that will occur


The intestinal bypass is partially reversible for those having malabsorptive complications


Carbs can be well absorbed, yet must be careful



The disadvantages of having the Duodenal Switch procedure are:


There is a chance of chronic diarrhea and possibly smelling stools and gas. This can be contributed to your dietary intake and can be controlled to avoid occurring


Malabsorption can lead to anemia, protein deficiency and metabolic bone disease in up to 5% of patients


You must keep a regime for daily intake of vitamins supplements for life, especially calcium, vitamin A, D, E and K