It’s no secret that obesity is a known cause of bad cholesterol, high blood pressure and increased risk of heart attack, stroke, type II diabetes and increased risk of developing certain cancers. Because of this, many patients are looking for safe ways to lose weight with surgery.
This surgical procedure combines both malabsorptive and restrictive surgical techniques. The first portion of the surgery is a partial gastrectomy where a portion of the stomach’s pouch is removed. This helps to reduce hormone secretion and also limits the stomach’s size. Both of these things have been shown to decrease hunger. This also alters the digestive process and helps to limit food absorption in the body. A patient will feel full quickly, which limits the number of calories that are consumed.
After the first step is completed, the surgeon will reroute the intestinal tract including small intestine changes. Duodenal switch doesn’t remove the entire pyloric valve unlike gastric bypass surgery. This helps to eliminate several negative gastric bypass side effects such as dumping syndrome.
The small intestine is altered so that the flow of food and the flow of bile and digestive liquids are separated. This helps to eliminate a lot of breakdown and the absorption of food into the intestines. Ultimately, fewer calories and nutrients are absorbed in each meal.
Risk of Vitamin Deficiency
While this promotes weight loss, it also leads to some nutritional or vitamin deficiencies in other patients. Many patients lack calcium and iron, which can lead to either osteoporosis or anemia. Other deficiencies can occur in Vitamins A, D, E and K, which if they go untreated can affect the nervous system. Protein deficiency also occurs in 18% of patients. This makes follow-up visits and regular blood test important for duodenal switch patients.
Weight Loss Success
Patients can expect to lose nearly 60-80% of their excess weight with duodenal switch surgery, most of which occurs during the first year. There is a 70% success rate for maintaining this weight loss for 8 years after the surgery.
Benefits of the Surgery
Many deem this the most successful bariatric surgical procedure for those with extreme weight loss. This is because it does not require any post-surgical adjustments like with gastric banding. It also requires less diet restrictions unlike gastric bypass surgery.
Many patients have found they can reduce their use of medications for Type II Diabetes, high blood pressure, arthritis, sleep apnea, cardiovascular disease or GERD following duodenal switch surgery.
Disadvantages of This Surgery
Many patients require lifelong dietary supplements because of the combination of malabsorption and restrictive techniques. The stomach also will increase in size which does not reverse. Gallstones are also common with this type of surgery, much like other bariatric surgery procedures.
Risks/Complications For Surgery
All surgeries have potential risks and complications. It’s important to discuss this with one’s surgeon before committing to the procedure. The biggest risk of this procedure comes with the way that food is absorbed, which could lead to nutritional deficiencies. Take regular nutritional supplements (approved by your doctor) and follow the dietary guidelines set forth for the post-duodenal switch diet. Also, eat lots of fat and protein which help to absorb nutrients even more.
Other potential complications as a result of surgery are dumping syndrome (1-2% of patient experience this), ulcers and blockage, all of which are very rare.
Candidates for Duodenal Switch Surgery
This powerful weight loss surgery requires that the patient does not have life-threatening diseases. Because of high expected weight loss, many patients will need to be evaluated thoroughly to determine their safety with having this procedure. Patients will need to have a BMI (body mass index) of 40 or more. For patients that are 35 or more in terms of BMI, they must have co-morbidities that make their risk of death from obesity high. These conditions include hypertension (high blood pressure), high cholesterol, type II diabetes, obstructive sleep apnea and metabolic syndrome.