Duodenal Switch Surgery - Obesity/Bariatric Surgery

Duodenal Switch Overview

A unique weight loss surgery performed by a limited amount of surgeons worldwide, the Duodenal Switch is also known as a vertical gastrectomy. Like other surgeries, it is designed to restrict the amount of food that can be eaten by a patient, prompting weight loss most effectively and powerfully in comparison with other weight loss surgeries. However, the procedure has more likelihood of complications associated with it, due to the nature of the vertical gastrectomy technique. Because of these additional risks, many insurance companies do not offer coverage for this type of surgery.

This weight loss surgery bypasses much of the intestinal tract, factoring in malabsorption as a main proponent of weight loss. Used in conjunction with a vertical gastrectomy which restricts the amount of food eaten, malabsorption is caused by a limited amount of food being absorbed into the body when an intestinal bypass or duodenal switch is present.

Common Duodenal Switch Treatment Procedure

With this weight loss surgery, there are two main proponents to the procedure. The first is restriction, or vertical gastrectomy. In this process, the stomach is divided vertically, and approximately 85% of the stomach is removed. Once this has been done however, patients need to realize there are no reversible options as there are in other weight loss surgeries. The surgeon reduces the size of the stomach, creating a banana-like shape. The nerves of the stomach and surrounding valves are kept in place so that the functions remain the same, but the overall size of the stomach is reduced.

Next, a section of the small intestine is bypassed. While the small intestine measures about 20 feet in length, roughly 10-12 inches of the beginning of the small intestine is named the duodenum, which is where the name duodenal switch originates. The surgeon takes the small intestine and cuts it in two places; one about two inches away from the pyloric valve, located near the stomach, and the other is eight feet from the bottom end of the small intestine. The surgeon then connects this bottom portions cut from the end of the intestine to the first portion, at the beginning of the duodenum. This procedure causes the biliopancreatic limb, where digestion occurs, to be totally bypassed but still able to transport bile and natural pancreatic secretions. The part of the small intestine where the food and digestive juices meet once again is  known as the common limb. Due to the small stomach size and the shortened section of small intestine, the absorption of calories and nutrients are drastically reduced, thereby causing significant weight loss.

Benefits of a Duodenal Switch Treatment

The benefits of the duodenal switch surgery is that patients are able to eat more food than those who undergo other forms of gastric banding or gastric bypass. Weight loss results are more significant than with other surgeries, and these results are longer lasting due to continued malabsorption. Despite the reduced stomach size being irreversible, the small intestines have the ability to be reattached to their original position, since none of them have actually been removed. However, other medical issues that result from obesity such as stomach ulcers, Type-2 diabetes, and high blood pressure have all been shown to be drastically reduced following this procedure.  One major advantage to the duodenal switch procedure is that super-obese or morbidly obese individuals who might have been turned down for other procedures may qualify for this procedure, and those who have a BMI of 55 or over find this surgery to be very effective. Those who undergo this treatment can expect to see a 60-80% total weight loss.

Cost of Duodenal Switch Procedure

Many bariatric surgery insurance companies and surgeons feel the duodenal switch procedure is experimental and therefore do not offer coverage. With the entire cost of surgery, the procedure totals approximately $45,000 in the United States, though patients in India pay around $15,000-$17,000 in India and those traveling to Mexico pay between $13,000-$17,000 for the same procedure.

Choosing a Weight Loss Surgeon

Before undergoing weight loss surgery, it is important to research doctors and make sure that he or she has had ample experience in that particular form of surgery. Since the duodenal switch procedure is not done frequently, it is important to find state-of the art facilities and  knowledgeable surgeons and hospital staff to perform the procedure. Always verify credentials, accreditation and expertise before choosing a particular bariatric surgeon for this procedure.