| Often referred to as simply a 'duodenal switch' | | | | close to the stomach outlet, to a point near the end |
| procedure, this particular form of bariatric surgery is | | | | of the intestinal tract, thus bypassing the bulk of the |
| in fact a vertical sleeve gastrectomy to which a | | | | digestive tract (typically about 500 cm will be |
| duodenal switch is added. This procedure is also | | | | bypassed). The result of this bypass (or duodenal |
| sometimes referred to as a biliopancreatic diversion | | | | switch) is that food passing through the intestine will |
| with duodenal switch. | | | | only mix with the body's digestive juices in the short |
| Of all of the different forms of weight loss surgery | | | | final section of the intestine below the switch, giving |
| available today this is perhaps the most controversial | | | | the digestive juices very little time to digest the food |
| and, though widely performed, there are many | | | | and absorb calories from it into the body. |
| surgeons who will not carry out the procedure | | | | While duodenal switch weight loss surgery has the |
| because of concerns about its long-term effects on a | | | | advantage of providing the patient with weight loss |
| patient's health. | | | | through both restriction and malabsorption, it is the |
| The first part of the procedure is a vertical sleeve | | | | degree to which the malabsorption element |
| gastrectomy in which the stomach is divided vertically | | | | predominates in the duodenal switch which gives rise |
| and approximately eighty-five percent is removed. | | | | to much of the controversy surrounding this form of |
| The small remaining 'sleeve shaped' stomach, which | | | | surgery. By comparison, the traditional Roux-en-Y |
| retains the original outlet to the intestines, functions | | | | operation has a much shorter bypass and the |
| very much as a normal stomach and this part of the | | | | distance over which food mixes with the digestive |
| surgery is designed purely to restrict the quantity of | | | | juices in the intestine is in the region of five times |
| food which can be consumed. This part of the | | | | greater. |
| operation is a form of 'restrictive' surgery and cannot | | | | The argument which many surgeons use against the |
| be reversed. | | | | duodenal switch is simply that so little absorption |
| The second phase of the operation is to create a | | | | takes place that there is too great a risk of anemia, |
| duodenal switch and this is a form of 'malabsorption' | | | | protein deficiency and metabolic bone disease. The |
| surgery which is largely reversible. Whereas restrictive | | | | vertical sleeve gastrectomy with duodenal switch is |
| surgery creates weight loss by physically preventing | | | | also arguably the most complex form of weight loss |
| the patient from eating too much food, | | | | surgery and many believe that it carries an |
| malabsorption surgery is designed to restrict the | | | | unacceptably high risk of complications. |
| body's ability to absorb calories from a meal as it | | | | Despite the risks however, the duodenal switch |
| passes through the digestive tract. | | | | remains a surgical option and can be very effective, |
| During the procedure the intestine is divided and a | | | | especially in patients with a very high body mass |
| small section (usually about 150 cm in length) is used | | | | index (BMI). |
| to create a bypass from the duodenum, which is | | | | |