Duodenal Switch Surgery

Bariatric surgical procedures that alter the gastrointestinal tract change signals that connect the gut to the brain and drastically increase the probability of lasting significant weight loss. This occurs even in individuals that have previously struggled to lose weight.

Duodenal switch surgery (DS) is a procedure that results in the greatest overall weight loss. In addition, it offers the best control of metabolic conditions, like diabetes. This particular bariatric procedure is less common because it is more complex; patients must commit to life-long vitamin supplementation and a diet of protein-dense foods. Further, physicians and the bariatric team must carefully monitor patients and provide education to reduce incidence of nutritional side effects.

What Is Duodenal Switch Surgery?

Duodenal switch surgery begins with a vertical sleeve gastrectomy that is intentionally made slightly larger than when a gastric sleeve surgery is performed as a stand-alone procedure. The purpose of this is to allow for greater intake of foods with a high protein content.

Within the digestive tract, there is a valve known as the pylorus. that marks the border between the stomach and the first portion of the intestine, or the duodenum. Approximately one inch past this border, the duodenum is divided. To reestablish a channel to food, an intestinal bypass is performed.  Classically, this has been done in an identical manner as a Roux-en Y Gastric Bypass. However, in a duodenal switch procedure, more bowel is bypassed. As a result, the surgery is labeled as malabsorptive, meaning that some of the nutrients consumed in food are not absorbed by the intestine. This results in a need for extra supplementation for effective nutrition.

The Duodenal Switch procedure for weight loss was developed by Dr. Douglas Hess in Ohio, while significant research demonstrating its long term effectiveness has come from Quebec in Canada. Our Surgeon has highlighted that the operation reduces the fluctuations in blood sugar that are commonly seen in gastric bypass, he has advocated bypassing less bowel to reduce the risk of nutritional deficiencies and diarrhea.

Who Should Have Duodenal Switch Surgery?

In theory, duodenal switch surgeries can be performed on any patient who meets the general requirements for bariatric surgery (see the BMI calculator). As compared to other bariatric procedures, DS surgery and its modifications have a better chance of helping patients with super morbid obesity to meet their weight loss goals. It also is more effective than other procedures for diabetes, especially in patients requiring insulin therapy for a prolonged period of time.  However, this effectiveness needs to be balanced with the higher risk of nutritional deficiencies.

Benefits of Duodenal Switch

There are many advantages to this type of surgery. Duodenal switch surgery is comparable to other bariatric surgery procedures but offers a healthy way to lose weight while still getting nutrients from food. Patients can eat healthy portions of food without feeling sick.

They also can properly digest food at the proper rate (no speeding up of digestion). The stomach’s ability to function properly isn’t impaired in any way. The pyloric valve remains intact, which means that patients are less likely to have blockages, dumping syndrome, or ulcers.

All of these results lead to weight loss. Losing weight helps to reduce the risk of obesity-related diseases (comorbidities) and improves existing medical conditions in patients. Patients will feel more confident and have more energy.

There are also risks associated with any weight loss surgery; however, our team will evaluate you and your particular medical history before recommending a treatment option. At Timo Clinic, we pride ourselves on being honest with our patients about all of the non-surgical and surgical options available


The amount of risk that a surgery holds will depend on how extensive it actually is. The duodenal switch surgery is a complex medical procedure. Ultimately, any surgery can potentially end up leading to a number of complications if patients are not careful.

As it is an aggressive procedure, a duodenal switch can result in many complications. Patients should be aware of these at all times. Some of the most common complications that can occur are leakage, abscesses, and infection. As well as these, it is also possible that blood clots may form in the legs. Bowel obstruction is another common complication and patients will also have a much higher risk of pneumonia.

Side Effects

There are side effects that can arise from the duodenal switch surgery which are borne out of the complications that can also occur. One of the positive effects of this surgery is that patients will experience a high level of weight loss.

Vitamin deficiencies are also quite common simply due to the fact that the patient will probably not be taking in as many vitamins as he or she used to because their food intake has been reduced. Some of the vitamins that you may be deficient in include vitamin D, vitamin A, protein, and calcium. In some cases, it may be necessary for patients to take supplements. Various forms of infection may also become more prevalent.

Who is a Suitable Candidate?

Those considering the duodenal switch surgery need to think very carefully about it (and any type of surgery) before making a decision on whether to have it. Ideally, those who undergo this kind of surgical procedure will be individuals who have no other choice.

Since it is such a large and dramatic change, patients will find that it can be life-altering. As a result, severely obese individuals are usually the ones who will take a look at getting this surgery done.

Post-Op and Dietary Concerns

After you have had the surgery and are out of the hospital, make sure to follow the specific food guidelines set out for you by your doctor and nutritionist. Patients must try to eat slowly until they feel full. Vomiting can occur if you eat too much. When it comes to medication, make sure to follow your doctor’s advice closely. Also, make sure only to shower and not bathe while the incision on your torso is healing.

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