Laparocopic Duodenal Switch – Ileal Transposition
The duodenal Switch (DS) surgery or ileal transposition is a modification of the BPD designed to prevent the ulcers, increase the amount of gastric restriction, minimize the incidence of dumping syndrome and reduce the severity of the protein-calcium malnutrition. However, the dumping syndrome is believed to be a benefit rather than a detriment which helps the patient to avoid eating sugary and high fat foods that would adversely affect the weight loss. These operations are some of the most complex in the bariatric surgery.
It causes restriction by reducing the amount of food you consume and also causes malabsorption by reducing the amount of calories that get absorbed by your body. Duodenal switch surgery is one of the major weight loss surgeries and it is also irreversible.
If your BMI is greater than 60, you may not be a good candidate for this approach.
If you are pregnant, you should not consider DS. If you are planning to get this procedure done, you should wait for a total of 18 months after the surgery before you get pregnant.
If you have had an abdominal operation before, you may have developed come scars as well as adhesions that can make DS more difficult and take a lot of time.
What to Expect with Duodenal Switch (DS)?
During this procedure, your surgeon will remove a large portion of your stomach and reroute your small intestine. Following this procedure, you’ll eat less and will absorb fewer calories that you eat. The duodenal switch surgery leads to rapid weight loss within 12 to 18 months following surgery.
Pre-Surgery Preparation: Before undergoing this surgery, your doctor will ask you to prepare in a number of ways. You’ll be asked to quit smoking 30 days prior to the procedure. You may need to take the vitamin supplements to prevent post-operative nutritional deficiency. Your doctor will want you to lose about 5 to 10% of your body weight before this surgery, in order to facilitate recovery and post-op weight loss. You’ll be asked to avoid alcohol for about 48 hours before the surgery.
The Surgery Itself: During this procedure, you’ll be given general anaesthesia and the surgeon will remove about 75 to 85% of your stomach along with the greater curvature. He will reroute the small intestine, leave the pyloric valve and part of the duodenum intact. Finally, you’ll have only 18 to 24 inches of small intestine left for the absorption of the nutrients from the food. The surgery can take up to 3 to 4 hours for completion. Your surgeon may elect to perform this procedure in two parts. You can expect to spend up to 4 weeks recovering from this procedure.
Postoperative Recovery: Immediately following this procedure, you’ll be able to eat liquid foods. You’ll gradually begin eating purees and then the solid foods as you begin to recover.