Duodenal Switch

What is the duodenal switch?

It is a weight loss surgery that combines gastric bypass and gastric sleeve procedures, based on removing about 70% of the stomach and leaving the rest of the stomach connected as usual with the first part of the intestine (the duodenum).
If you are obese and trying unsuccessfully to control your weight, your doctor may recommend a duodenal switch.
This surgery helps to lose more weight than gastric bypass and sleeve gastrectomy. It has been proven that this surgery helps get rid of obesity and any related diseases.

Who should have the duodenal switch operation?

Dr. Ahmed Shabana recommends a gastric reduction duodenal switch procedure for those whose body mass index (BMI) is more than 50 or more than 40 with type 2 diabetes and some other serious diseases, such as:

• Sleep apnea.
• Heart or lung diseases.
• High blood pressure.
• High cholesterol.
• Non-alcoholic fatty liver disease.

How is it performed?

First, a sleeve gastrectomy is performed. To do this, a large portion of the stomach is removed with a stapling tool, leaving you with a narrow tube, from top to lower stomach. After that, the stomach becomes smaller to hold a small amount of food, and the patient feels full quickly.
The second stage of surgery redirects food away from the upper part of the small intestine, which is the normal pathway for digestion. This reduces the number of calories and nutrients that your body can absorb. The small intestine divides and a connection is made near its end.
In the final stage of the operation, one end of the small intestine connects to the duodenum near the bottom of the stomach, and the natural way in which bile and the digestive system digest food changes. This reduces the number of calories absorbed by the body, causing more weight loss.

Advantages of the GRDS

This surgery reduces the size of your stomach to only about 30% of its normal size, and this results in losing a lot of weight, which is estimated at 70 kilograms, because it limits the amount of food you can eat, and also reduces the number of calories and fat that you can absorb.
It reduces the secretion of ghrelin, the hunger hormone, and inhibits the body's desire to store additional energy in the form of fat.
It also helps control diabetes in the long term, better than gastric bypass or sleeve gastrectomy.
This operation affects the type of microbiome existing in the digestive system, as good bacteria replace harmful ones, which supports weight control and maintenance.

After surgery phase

Recovery

Usually, the patient stays in the hospital for 1 to 3 days after the operation. The doctor will want to see you to monitor your health condition two weeks after surgery.

Diet

After having this type of surgery, you will not have symptoms of dumping syndrome, but you will need to take extra daily vitamins on a regular basis for the rest of your life.
You should not stop taking any vitamins your doctor prescribes, not to develop a deficiency of vitamins or minerals necessary for the body.
The nutritional supplements that the patient must take after the procedure:

• Multivitamins.
• Calcium.
• Iron.
• Fat-soluble vitamins (A, D, E, and K).
• Probiotics.

Dr. Ahmed Shabana recommends eating small meals rich in protein, along with fruits, vegetables, whole grains and omega-3 fatty acids, and avoiding meals rich in sugar.
It is imperative to do routine blood tests and follow-up with your doctor, to make sure that your body is getting enough nutrition and supplements.
The patient needs to understand that following a healthy lifestyle is necessary to maintain weight loss after surgery, and this includes a healthy diet and plenty of regular exercises, and it also requires a lifelong commitment, with regular visits to the doctor for periodic lab examinations.