Duodenal Switch

What is a Duodenal Switch?

The Duodenal Switch is an operation that combines the stomach reconfiguration of a Sleeve Gastrectomy with an intestinal re-routing that is seen in procedures such as the Gastric Bypass. The sleeve gastrectomy involves surgically removing approximately 85% of the stomach, the edges are then typically stapled or stitched together to form a tube or sleeve shape thus reducing stomach volume and minimizing the amount of food one can eat comfortably, as well as minimizing hunger-inducing hormones.

duodenal-switch-bariatric-surgery-diagramThe procedure is then followed by an intestinal re-routing bypass which connects the stomach to the small intestine at a lower point than when it once had, thus causing digestion to happen further along the digestive track and causing fewer calories to be absorbed. Due to the complexity of the procedure it is usually completed in two stages, the first being the sleeve gastrectomy and the second being the intestinal re-route bypass completed around 6-12 months following. Despite this, it boasts the largest long-term weight loss and health improvement of any other procedure.

Am I eligible for a Duodenal Switch?

As the Duodenal Switch is such a major weight loss procedure it is not recommended for everyone. Patients can expect to lose around 65% of their excess body weight within the first 12 months thus this procedure isn’t recommended for patients wishing to lose a small percentage of body weight or aim to sculpt certain areas.

Eligible patients that are usually considered for this procedure include those who have a BMI over 40 or a BMI over 35 and suffer from serious health conditions such as high blood pressure, high cholesterol, type 2 diabetes, sleep apnea or any other related conditions. This procedure is mostly recommended to rather morbidly obese patients with a BMI of around 50 and over due to its ‘extreme’ weight loss nature of the procedure. Due to the recommendation to the larger spectrum of patients, the rate of complications tends to be much higher risk than what it actually is.

Advantages of a Duodenal Switch

  • The majority of weight loss occurs very rapidly after surgery (65% in the first 12 months and around 80% in 24 months), with some studies showing long-term weight loss to exceeding 90%.
  • 95% of patients report a higher quality of life after the operation.
  • Patients will be limited to a portion size of around 25% of what they once were, restricting patients from overeating leaving them fuller quicker, for longer.
  • Obesity-related health conditions including type 2 diabetes, high blood pressure, sleep apnea etc are improved if not resolved in the following months after the procedure.
  • More resistant to weight regain when compared to other procedures such as the gastric bypass.

Risks and Complications of the Duodenal Switch

As with any surgical procedure a range of possible complications are introduced, these include:

  • As this procedure involves stomach stapling there is a risk of leakages or other issues that may occur from this.
  • Higher complication rate when compared to other bariatric procedures due to the complexity of the operation.
  • Vitamin deficiencies or malnutrition may occur due to the intestinal re-routing.
  • This operation is considered an irreversible procedure!
  • May induce various digestion issues such as difficulty swallowing or change in bowel movements.
  • Patients may induce or worsen reflux symptoms such as heartburn

Cost of the Duodenal Switch

Like most surgery there is never one definite cost for a specific procedure, this is due to the different elements involved that make up the final cost. Depending on your Private Health Insurance it could cost anywhere between $6,000 – $10,000 after rebates, on the other hand, if you do not have insurance it could cost anywhere between $29,000 – $55,000 with the average cost around $33,000. Some of these ranging factors include that will influence these numbers are:

  • Consultation fees – Usually between $100-$200 that are usually eligible for a medicare rebate.
  • Surgeons fees – Usually one of the most varying factors. This is commonly correlated with the surgeons’ experience and ability.
  • Surgical assistants fees
  • Anaesthetists fees
  • Hospital/Facility fees
  • Type of Surgery
  • Post Operative Medication/Vitamins

It is important to not to take shortcuts with surgery, these are life changing operations that if not done correctly or properly by a competent and experienced surgeon could lead to some serious medical issues later down the track. It is not advised to travel to third world countries in order to find the cheapest deal possible as often you are left with a second rate surgery in a second rate theatre with no post-operative support later on. While saying that it is important to be able to tell the difference between a highly experienced surgeon who charges a bit more and a second rate surgeon who charges the same price.

After the Duodenal Switch

After your surgical procedure, the duodenal switch has a hospital stay period of around 2-3 days with patients commonly back to work within two weeks. A diet of full liquids is prescribed during the first few weeks before slowly progressing to purees and then soft foods all within a 4 week period. It is important in this time to drink lots of water and fluids as dehydration is common in patients postoperative. The final stage is progressing to solid foods that will be the basis of forming the new ongoing diet, during this time patients should tend to begin the transition to a more exercise filled lifestyle in order to maximize weight loss and reduce the chance of weight regain.

Patients can expect to lose about 30% of excess body weight just within the first 12 weeks, and expect to lose a majority of their total excess weight loss within the first year after the procedure, with a slight decrease in the following year and another in the years following it.

To find a surgeon near you visit our Plastic Surgeons Directory HERETo find more information send us an enquiry below or call us on (03) 8849 1464 and we will be happy to answer any questions you may have.