Duodenal switch is the newest option for weight loss surgery at Middlesex Health. It can help patients achieve significant weight loss and has been shown to improve and even reverse weight-related conditions, such as diabetes.

The duodenal switch procedure combines some elements of gastric sleeve procedures with intestinal bypass. It can be performed as either a one- or two-part minimally-invasive procedure.

Part 1

The first part of this surgery is the creation of a gastric sleeve.
For many, the first surgery–the creation of the gastric sleeve–may be all that is required to lose significant weight.

Part 2

If you have poorly-controlled diabetes, or a BMI greater than 50, a second surgery may be needed. It can be performed at the time of the initial surgery or years later if the gastric sleeve alone does not help you achieve your weight loss goals.

This second surgery is called an intestinal bypass duodenal switch. Your surgeon will create a bypass to redirect food to the lower part of your small intestine. This limits the amount of calories and nutrients you absorb from food (malabsorption) and helps you lose weight.

The procedure will help people lose weight in three ways:

• Your new, smaller stomach can only hold a limited amount of food. This means that you will feel full sooner and for longer, contributing to an overall drop in your dietary intake.
• Next, the procedure will reroute food away from the upper part of the small intestine, which aids in digestion, cutting back the nutrients and calories absorbed in the body.
• Finally, the surgery alters how digestive juices work to break down ingested food, which also reduces caloric intake.

There are two minimally invasive ways to perform the duodenal switch using the da Vinci® robot, a Single anastomosis duodeno–ileal bypass with sleeve gastrectomy (SADI-S) or a Stomach Intestinal Pylorus-Sparing (SIPS). In both procedures, the stomach's size is reduced, and the intestinal path is shortened, limiting the amount of food your stomach can hold and the amount of calories and nutrients you absorb from food. Your surgeon will discuss the details of each procedure to determine the best approach for you.