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Duodenal Switch DS: The Guide To Weight Loss!

Duodenal Switch surgery

What Is Duodenal Switch?

Duodenal switch is a weight loss surgery in which approximately 70 percent of the stomach is cut and removed from the body, along with a minor portion of the proximal part of the small intestine, hence the name duodenal switch (duodenum=small intestine). The food intake capacity is thus reduced drastically as the individual starts feeling full after eating two or three bites or morsels of food. This is a major contribution in the weight loss for heavy and obese individuals who find it hard to workout vigorously and mobilize their fats.

Why Is Duodenal Switch Needed?

Indications for a duodenal switch are as follows:

  • Individuals who have a lethargic and sedentary lifestyle
  • Heavy and very obese individuals
  • BMI basal metabolic rate is in the range of 30 to 40, or even above
  • Excess fats deposition in the neck and chin area leads to sleep apnea causing difficulty in breathing and breathlessness
  • No amount of physical exercises or exertion or a monitored diet is now able to help you reduce your weight and shed the excess kilograms from your body
  • You are obese owing to secondary hypothyroisim, polycystic ovarian disorder or cushing’s syndrome and thus find it difficult to reduce weight
  • Your obesity is a major contribution from the medications you take such as anti depressants, corticosteroids and anti epileptics

Signs And Symptoms A Duodenal Switch Is Needed:

  • Increased body mass index BMI, reduced basal metabolic rate BMI
  • Lethargic lifestyle and attitude
  • Increased blood pressure, high pulse rate, raised blood sugar levels
  • Lack of physical activity and a very sedentary lifestyle
  • Excessive consumption of fats, cholesterol, alcohol
  • Visible fatty and chubby appearance
  • Appearance of chunks of fats all over the body, especially arms, chest, stomach, thighs and buttocks

Diagnosis Required Prior To Duodenal Switch:

  • A body mass index test is run on the patient, where levels above 30 to 40 confirm that the individual is apt for a duodenal switch
  • Basic tests such as complete blood count, hemoglobin estimation are done so as to get an estimate of the overall health of the individual
  • Monitoring of weight on a weekly basis, if it remains constant even after a reduction in diet and excessive workouts, it surely calls for a duodenal switch surgery
  • Thyroid function test is done to assess for hypothyroidism
  • Ultrasonography USG of the upper abdomen to assess the positions and anatomy of the stomach and the small intestine
  • Very rarely  an upper GIT endoscopy maybe done to rule out any pathology in the stomach and intestinal curves

Treatment Procedure For A Duodenal Switch:

Duodenal switch is one of the most complex bariatric surgery procedure that is generally done in three steps.

In step one, a sleeve gastrectomy is done. In this procedure, a long suture is made in the upper central portion of the abdomen and three fourths of the stomach including the fundic part is removed. This leaves behind a small tube or sleeve like part of the stomach starting from top to bottom. Thus the only part of the stomach you have now is the tube or sleeve portion. With this volume of stomach left inside you, you eat less because you feel full very soon. In step two, food is rerouted away from the upper part of the small intestine which is usually the natural pathway for digestion. This cuts back on how many calories and nutrients your body is able to absorb. The small intestine is divided and a connection is made near the end of the small intestine. The step three changes the normal manner in which bile and other digestive juices break down the food particles. This cuts back on how many calories you absorb, causing still more weight loss. One end of the small intestine is connected to the duodenum, near the bottom of the stomach. 

The duodenal switch can be done either laparoscopic or by the conventional open surgery. In the open surgery, a cut or an incision is made in the belly. Contrary to this, the laparascopic approach will require even smaller cuts both in number as well as in length.either BPD/DS is done as either laparoscopic or traditional open surgery. In open  surgery, the healthcare provider makes a cut in your belly area. Thus the instruments used will be smaller, the illumination gadgets used too are small. Laparoscopic surgery can help you recover more quickly and may reduce the risk for complications, such as infections and hernias. Some bariatric surgeons use a laparoscopic surgical robot to help in certain parts of the operation. 

Complications And Risk Factors Associated With Duodenal Switch:

  • Indigestion, diarrhea, nausea, vomiting, abdominal cramps.
  • The important gut bacteria are also removed along with the portion of stomach, this may add to indigestion
  • Non healing ulcers are quite common after such a surgery since the vitamin C levels go drastically down in such individuals. This is because the bacteria required for the absorption of the vitamin are no longer available. However this condition can be totally cured by the oral administration of vitamin C under the supervision of the general physician or the gastroenterologist.
  • Infections at the site of wound, scars, keloid formation, bleeding may also occur
  • Excessive or unwanted weight loss 

Am I Good Candidate For Duodenal Switch?

You will be considered an ideal candidate for a duodenal switch, if you suffer from any of the following symptoms:

  • No amount of physical exercise is helping you reduce your weight
  • The same follows for the diet, monitoring of the diet also does not help in reduction of the fats
  • You are diagnosed with class I or II obesity
  • You are suffering from cushing’s syndrome, hypothyroidism or polycystic ovarian disorder which is why the shedding of the extra kilograms has become difficult for you

Recovery Time of Duodenal Switch surgery:

The ideal time of recovery from a duodenal switch procedure is three to four weeks after which the patient can start with regular exercises and diet. During this period it is mandatory for the individual to check for any complications and report to the doctor concerned. the healing and recovery period however can vary from person to person depending upon the host response.

Success Rate of Duodenal Switch surgery:

The success rate of a duodenal switch procedure largely depends upon the dietary monitoring and motivation for physical exercises. Patients undergoing a duodenal switch fail to gain weight even after ten years post the surgical procedure, contributing to about 90 percent success of the procedure. The same weight can be maintained for a period of 15 to 18 years without the need for any second surgical intervention.

Benefits of Duodenal Switch surgery:

A duodenal switch has the following advantages:

  • Weight loss happens very quickly since there is a substantial malabsorption of the calories
  • Significant and visible reduction in the body fats
  • You feel full after eating very less, since the volume of the stomach is drastically reduced

Cost Comparisons For Duodenal Switch surgery:

You will be required to pay a cost of 2,50,000 INR for the duodenal switch surgery here in India, minus the hospital stay and the post operative care and medications which will be roughly around 50,000 INR. This amount is peanuts as compared to the cost you will be expected to pay in countries abroad, probably the Indian cost is 60 percent lesser than the fees you will be paying there.

Why choose India?

A tremendous variety of treatment procedures are carried out in India, with the duodenal switch surgery being one of them finding a place in every hospital here. Team MedcureIndia highly recommends the duodenal switch procedure to be followed here considering the low cost, high efficiency and excellent results.




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