Duodenal Switch

Duodenal switch is a surgical operation that combines sleeve gastrectomy and gastric bypass. While duodenal switch enables patients to lose weight, it also helps them get rid of obesity-related diseases. The duodenal switch, which is preferred particularly in diabetic patients with a high body mass index, can be performed in a single time or, it can be applied in stages. In the first stage, sleeve gastrectomy can be performed, and gastric bypass surgery can be performed 6-18 months later. The duodenal switch allows patients to get rid of more than 70% of their excess weight.

Who Can be a Good Candidate for the Duodenal Switch?

Duodenal switch is the best and most comprehensive bariatric surgery procedure for patients with diabetes, high blood pressure, high cholesterol, and high triglycerides. Patients who consume high calories daily and are overweight are suitable candidates for the duodenal switch.

The Procedure

In duodenal switch surgery, which is performed in two steps, approximately 80% of the stomach is removed using sleeve gastrectomy and gastric bypass. The stomach is made into a thin tube and is designed with a volume of 120 ml with the sleeve gastrectomy procedure, t. In the second step, a common channel is opened in two separate ways by separating the small intestine to form the bypass. In sleeve gastrectomy surgery, what the patient eats goes to the stomach and then to the small intestine, while with the duodenal switch surgery, the foods are directed to the lower part of the small intestine. Since the stomach volume is reduced, the patient reaches the feeling of satiety with less food. By shortening the paths in the intestines, the patient's intestines absorb less food, and the amount of calories taken from food is also less.

The two procedures used in duodenal switch surgery are either combined or applied separately. Bypass surgery can be performed 6-18 months after sleeve gastrectomy. 

Duodenal switch surgery can be performed with several different techniques. These techniques are robotic surgery, open surgery, and laparoscopic surgery.

In the robotic surgery (Robot-assisted minimally invasive surgery) method, several small incisions are made on the patient's abdomen. The surgeon performs the surgery from the surgeon's console, which is a few steps away from the patient. Another surgeon helps the surgeon at the console by including the necessary materials or instruments during the operation. The robot's special camera provides the surgeon on the console with a 3D view of the patient's interior, which can be enlarged up to 16 times, and the image is transmitted to the operating room and guides the surgeon and nurse. The console eliminates hand tremors in all movements of the surgeon. Small incisions in robotic duodenal switch surgeries are advantageous in terms of facilitating the healing process.

Open duodenal switch surgery is performed through a large incision in the patient's abdomen. Since the surgical incision is larger, the healing process is more challenging and takes more time.

Small incisions are made, as in robotic duodenal switch surgery in laparoscopic surgery (minimally invasive surgery). The surgery is performed with laparoscopic instruments following the 2D image provided by a camera called the laparoscope.