How Safe Is The Gastric Sleeve With Duodenal Switch?

Tuesday, January 27, 2009 at 3:18 am under Weight Loss How Safe Is The Gastric Sleeve With Duodenal Switch?

by Donald Saunders

Of all of the different forms of weight loss surgery which are nowadays the sleeve gastrectomy with duodenal switch is perhaps the most controversial and, though it is widely carried out, there are a lot of surgeons who are not prepared to carry out the procedure as a result of worries about possible adverse long-term effects on a patient’s health.

Usually simply known as a duodenal switch, this particular form of bariatric surgery is in fact nothing more than a sleeve gastrectomy to which a duodenal switch is added. This procedure is also occasionally called a biliopancreatic diversion with duodenal switch.

The initial part of this procedure is a sleeve gastrectomy in which the stomach is divided vertically and approximately eighty-five percent is removed. The small sleeve shaped stomach which remains retains the original outlet to the intestines and functions just like a normal stomach. This initial part of the surgery is aimed purely at restricting the quantity of food that can be consumed and this restrictive surgery cannot be reversed.

The second phase of the operation is to make the duodenal switch adding in an element of malabsorption surgery that is largely reversible. Unlike restrictive surgery that causes a loss in weight by physically preventing the patient from eating too great a quantity of food, malabsorption surgery contols the body’s power to absorb calories from a meal as it passes through the digestive tract.

During surgery the intestine is divided and a relatively small section (generally approximately 150 cm in length) is used to make a bypass from the duodenum, which is situated near to the outlet of the stomach, to a point near the end of the intestinal tract thereby bypassing the major part of the digestive tract. The consequence of this duodenal switch is that food that passes through the intestinal tract only mixes with the body’s digestive juices in the short final section of the intestine below the switch thus allowing the digestive juices very little time to digest the food and absorb calories from it.

Despite the fact that duodenal switch weight loss surgery enjoys the advantage of providing weight loss using both restriction and malabsorption, it is the extent to which the malabsorption element dominates in the duodenal switch that gives rise to a lot of the argument which surrounds this type of surgery. By way of comparison, the traditional Roux-en-Y operation has a much shorter bypass and the length of intestine over which food is digested is about five times greater.

The argument that many surgeons use against the duodenal switch is simply that insufficient absorption takes place so that there is too great a danger of anemia, protein deficiency and metabolic bone disease. The sleeve gastrectomy with duodenal switch is also debatably the most complicated type of weight loss surgery and a lot of surgeons think that it carries an unacceptable level of risk.

Regardless of the risks the duodenal switch is nevertheless a surgical option and can be very effective, particularly in people with a very high body mass index.

About the Author:

GastricBypassFacts.info provides detailed information on all aspects of obesity surgery including details of the gastric sleeve with duodenal switch

Written by: Donald Saunders

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