Another advantage of the duodenal switch weight loss surgery, in comparison to traditional gastric bypass surgery, is the preservation of the sphincter between the stomach and small intestines. This prevents dumping syndrome, the movement of food into the intestines before it has undergone some digestion in the stomach. Because the digestion process is improved in this type of weight loss surgery, patients can have a more varied diet than those who have traditional bypass surgery. With the duodenal switch procedure, the incidence of malnutrition and vitamin deficiencies often experienced by traditional bypass patients is greatly reduced, as the digestion and absorption of most nutrients is not as restricted.

Studies have shown that duodenal switch surgery has a significant positive impact on obese patients with type-2 diabetes. Very soon after the surgery, glucose regulation returns to normal in the vast majority of patients. It has also been shown to restrict fat absorption, reducing the incidence of excessive levels of fats in the bloodstream. Both of these improvements positively affect other aspects of health including cardiovascular health.

Duodenal switch surgery does require a hospital stay. General anesthesia is used and patients are monitored after the surgery to prevent any complications. Patients in Dallas and Fort Worth, Texas, are encouraged to discuss the various types of weight loss surgeries with their doctors to determine which would provide optimal results for their individualized needs.

I’m Steve and I’m a family physician. I also suffered from severe morbid obesity for decades and knew that I needed to look into something to give me back the quality of life that I deserved. Prior to undergoing duodenal switch in December 2009, I suffered not only from severe morbid obesity, but also type 2 diabetes, hypertension, hyperlipidemia and obstructive sleep apnea. I topped out at a maximum weight of 342 lbs and a body mass index of well over 50. Quality of life-wise, things were just not good. It was difficult to get through the day to day. It’s hard as a physician to be of that size and that stature. A lot of people would seek me out as their doctor just because they knew I wouldn’t gripe at them if they came in for their annual and had gained a few pounds. So it began to affect me not only on a personal level, but also on a professional level.

It was at that point that I started researching bariatric options very seriously and looked into all of the different procedures available and who offered those procedures. I chose the duodenal switch procedure because it has a 99% cure rate for type 2 diabetes and at the time, I was on insulin and nine prescription pills with close to a $400 a month pharmacy bill. Within two weeks of my duodenal switch procedure, my sugars were back to normal levels. I stopped all medications the day before surgery and the only medication I’ve taken since was an acid blocker for six months after surgery. Duodenal switch helped me lose 173 lbs in 10 months. I lost all of my co-morbid conditions. I no longer have morbid obesity and I’m not even overweight anymore. My hypertension is gone and my hyperlipidemia is gone. In fact, I had my cholesterol checked at the one-year mark, and while my total cholesterol before surgery was in the high 200’s on medication, after surgery it was 86 off all medications and pretty much eating a regular diet. Duodenal switch is the best decision I’ve ever made.

I have every confidence in Dr. Stewart. He’s done a lot of duodenal switch procedures and he’s an excellent surgeon. In Texas alone, there are over 450 bariatric surgeons and of those only four offer the duodenal switch. I think that speaks to the caliber of physician that offers this procedure.

Teri:  Hi I’m Teri. I had my surgery not quite a year ago, I had to do a duodenal switch and I’ve lost 153 pounds so far.

Before surgery I had sleep apnea that was my main problem. I also a condition called sarcodosis which effects the lungs and I was short of breath I had trouble breathing and I had two small children that were very hard to keep up with. I really wanted to improve my quality of life for them – to be around for them. I am a single parent so it was hard to consider weight loss surgery wondering how it would affect my family if something happened and the complications. But I am a registered nurse and I felt that it was important to do something proactive to be there for the long term for them.

There have been many positive aspects regarding the surgery. For the first time I understand what it feels like to be full. Before I would just eat and eat and it was a way of coping and now physically I can only eat so much and I have to stop and I realize how much I was really overeating. Basically medicating myself with food it was a way of stress management for me. If I had a bad day or if something was going on in my life I would turn to food and that was my coping. Now I might go for a walk or go do some retail therapy but it might be at like a thrift store or something like that not to an extreme. Or spend some time with the kids and do other activities. The good part is I’m really more focused more on my nutrition and making sure that I get my protein in and having more of a well balanced diet.

With the surgery I am forced to think about those things were as before it was just doing a diet that type of thing you could always maneuver around it and find ways to sneak things in. But it is very important to realize that you have to for the rest of your life watch your protein, watch your vitamin intake, you have to realize this is a life changing thing but you have to be responsible and be ready to do all those things when you make that decision.

Duodenal switch surgery does not bypass the stomach. Instead, it actually removes 75% of the stomach and rearranges the small intestine so that the section carrying food from the small stomach does not join with the section carrying digestive juices until very far downstream. This decreases the amount of fat and calories that are absorbed from foods eaten.

Dr. Vivek Prachand of the University of Chicago studied 350 patients who were an average of 200 pounds over their ideal weight. 198 patients underwent duodenal switch surgery and 152 patients had gastric bypass surgery. The researchers followed the patients for three years after surgery and found that the duodenal switch resulted in greater total weight loss, a greater percentage of excess weight loss, and lower BMI.

The study also showed that people who opted for duodenal switch surgery were less likely to need medication for diabetes, hypertension, and dyslipidemia. A full 100% of diabetes sufferers who underwent the duodenal switch surgery were able to stop taking diabetes medication three years after surgery, compared to only 60% of gastric bypass patients.

The only area that gastric bypassed seemed to address better than duodenal switch was acid reflux.

Although duodenal switch surgery seems to be a better option for weight loss and health related problems than gastric bypass surgery, it accounts for less than 10% of weight loss surgeries in the United States at this point. If you’re considering weight loss surgery, you may want to investigate whether any surgeons in your area offer the duodenal switch procedure.

Duodenal switch surgery is a more complicated procedure than some of the other weight loss surgeries; but it can be a good choice for a variety of reasons. Basically, this surgery works to restrict the amount of food that can be eaten as well as bypassing most of the duodenum causing less food to be absorbed by the body.  Although a significant amount of the stomach is removed during the surgery, it differs from gastric bypass by retaining the valve between the stomach and the intestines known as the pylorus. Retaining this valve eliminates the problem of dumping syndrome that gastric bypass patients sometimes experience.  The incidence of stomal ulcers which can occur after gastric bypass surgery is also reduced because of the technique used for making the stomach smaller does not include creating a stoma.

Even though the size of the stomach is restricted, it is less than either gastric bypass or gastric banding and so the diet of a duodenal switch patient is much closer to normal than with the other procedures.  This aspect of the procedure generally results in a higher degree of satisfaction among patients who have duodenal switch. Additionally, the removal of the left half of the stomach takes with it the area where most of the hunger hormone ghrelin is produces.  This results in reduced appetite following duodenal switch.

Weight loss from the duodenal switch is estimated between 60 and 80% of excess weight, which is higher than other weight loss procedures.  

Although duodenal switch offers several advantages over other weight loss procedures, it is a major surgery that requires lifelong changes in behavior for it to be successful.  Its complexity restricts the number of surgeons offering doudenal switch surgery, so it is frequently not presented as an option for people suffering from obesity who may benefit from the procedure.