The Duodenal Switch (DS) procedure, also known as biliopancreatic diversion with duodenal switch (BPD-DS), is a weight loss surgery procedure that combines restrictive and malabsorptive aspects.
The restrictive portion of Duodenal Switch surgery involves removing approximately 70% of the stomach along the greater curvature, essentially creating a larger-size Sleeve Gastrectomy. The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver and digestive enzymes from the pancreas to the common channel.
The common channel is the portion of small intestine, usually 100-125 centimeters long, in which the contents of the digestive loop mix with the contents from the biliopancreatic loop before emptying into the large intestine. The objective of this surgical reconfiguration is to reduce the amount of time the body has to capture calories from food in the small intestine and limit the absorption of fat by 70% or more. Because the pyloric valve between the stomach and small intestine is preserved, people who have undergone duodenal switch surgery do not experience dumping syndrome (rapid gastric emptying, abdominal cramps and diarrhea) common with those who have undergone the Roux-en-Y Gastric Bypass.
The DS is done in our practice by laparoscopic, or minimally invasive, surgery through a few small incisions using small instruments and a camera to guide the surgery, and typically requires a two-day hospital stay. Laparoscopic surgery allows for faster recovery, less post-operative pain and fewer wound complications, such as infections and hernias, than open surgery.