Duodenal switch surgery is a surgical operation that combines both sleeve gastrectomy and gastric bypass. The process is carried out in two steps. First, a sleeve gastrectomy is performed in which approximately 80% of the stomach is removed, and the remainder is formed into a thin tube. As a result, the stomach with a volume of 1.5-2 L takes the form of a light and long line with a volume of about 120 ml. This part of the surgery is now an irreversible surgical procedure.

Then, to create a bypass, the small intestine (duodenum), which usually connects to the stomach, is separated, and two paths and a common channel are created. The foods consumed are generally directed to the lower part of the small intestine and go to the colon from the stomach, which remains in the form of a tube after sleeve gastrectomy. In contrast, they should go to the beginning of the small intestine. This sleeve is the short part of the small intestine that is separated after gastrectomy. The other route, which consists of the longer part of the small intestine, is the part where bile and other digestive enzymes mix with food and cause absorption, the length of which is reduced to 250 cm. As a result, since the stomach volume remains very small, the patient reaches the feeling of satiety by eating less, and the amount of calories remaining from the food to the body is less since the nutrients are absorbed less because the paths in the small intestine are shortened.

This method, generally applied in diabetic patients with a high body mass index, can be performed in a single operation, but it is also possible to use it gradually. A different surgery can be performed for bypass 6-18 months after sleeve gastrectomy is performed in the first stage. With this method, patients can lose 70-100% of their excess weight.

Surgical Methods That Can Use in Duodenal Switch Surgery

Duodenal Switch Surgery with Robotic Surgery

Robotic duodenal switch surgery is performed through several small incisions in the patient’s abdomen. The surgeon operates the surgeon’s console, which is a few steps away from the patient during the operation. At the same time, another surgeon at the head of the patient helps the surgeon at the console by including the necessary materials or instruments during the operation. The particular camera of the robot provides the surgeon on the console with an accurate 3D view of the inside of the patient, which can be enlarged up to 16 times. The image is transmitted to the operating room and guides the surgeon and nurse at the bedside. The console instantly sends the surgeon’s movements into the patient more sensitively and sharply, eliminating hand tremors. The small incisions in robotic duodenal switch surgeries allow patients to return to their daily lives more quickly.

Open Surgery

Open duodenal switch surgery is performed through a large incision in the patient’s abdomen. The size of the incision prolongs the recovery time after the operation. The most significant advantage of open surgery is that the surgeon operates by feeling the tissues.

Laparoscopic Surgery

As in robotic duodenal switch surgery, the operation is performed through small incisions in the patient’s abdomen. The surgeon on the patient’s head operates with long, flat laparoscopic instruments accompanied by a 2-dimensional image provided by a camera called a laparoscope.

Why is Duodenal Switch Surgery Preferred?

• Statistically, the most comprehensive weight loss method among surgical interventions
• The most suitable method for diabetes, high blood pressure, high cholesterol, and high triglyceride
• The most effective solution for patients fed with high calories
• It does not cause indigestion as the “pyrrolic valve” of the stomach is protected.
• Since the part of the stomach that produces GHRELIN (hunger hormone) is removed, it causes a decrease in hunger and appetite.
• Overweight patients also help you lose weight better than a clamp and Gastric Bypass methods.

Benefits

The Duodenal Switch procedure makes it easier to lose weight as it limits the amount of beverage consumed. Thus, the amount of calories entering the body is also reduced. Duodenal Switch surgery leads to more weight loss as it directly affects the metabolism and is a more effective method in the treatment of diabetes, hypertension, and high cholesterol diseases, mainly due to excess weight. Since it is an application that reduces fat absorption, it is a method specially developed for patients who consume fatty foods.

Its effects on metabolism are more pronounced in terms of slowing down fat absorption, thus facilitating and helping to lose weight over a long time. Although it is the most effective of the four surgical methods that provide weight loss, post-operative risks may be higher. Only 50 bariatric surgeons in the world can perform this operation due to the long-term effects of fat absorption slowdown, the skill of the method, and the long post-operative examination period.