Duodenal switch, also known as biliopancreatic diversion with duodenal switch, or vertical gastrectomy, is an effective weight loss procedure. This procedure provides long-term weight loss for those people who are severely obese. The duodenal surgery basically limits the amount of food that a stomach can hold and number of calories that can be easily absorbed by the body.
The initial part of this procedure is a sleeve gastrectomy in which the stomach is divided vertically and approximately eighty-five percent is removed. The small sleeve shaped stomach which remains retains the original outlet to the intestines and functions just like a normal stomach. This initial part of the surgery is aimed purely at restricting the quantity of food that can be consumed and this restrictive surgery cannot be reversed.The second phase of the operation is to make the duodenal switch adding in an element of malabsorption surgery that is largely reversible. Unlike restrictive surgery that causes a loss in weight by physically preventing the patient from eating too great a quantity of food, malabsorption surgery contols the body's power to absorb calories from a meal as it passes through the digestive tract.During surgery the intestine is divided and a relatively small section (generally approximately 150 cm in length) is used to make a bypass from the duodenum, which is situated near to the outlet of the stomach, to a point near the end of the intestinal tract thereby bypassing the major part of the digestive tract. The consequence of this duodenal switch is that food that passes through the intestinal tract only mixes with the body's digestive juices in the short final section of the intestine below the switch thus allowing the digestive juices very little time to digest the food and absorb calories from it.
This procedure is also termed as biliopancreatic diversion with duodenal switch that helps in weight reduction of about 45-55% of excess body weight. This range is much higher as compared to laparoscopic adjustable gastric banding procedures. One of the advantages of sleeve gastrectomy is that it preserves Pyloric Valve which regulates the emptying of the stomach while preserving certain centimeters of the duodenum. This procedure is performed laparoscopically where a small stomach pouch of 120cc size is created with the help of stapling devices. The remaining stomach part is also removed. In this procedure the stomach is simply reduced and the gastrointestinal tract is not changed.This procedure effectively limits the food intake that provides for maximum weight loss. A sleeve gastrectomy patient will now be able to eat a cup of food in three times a day and will feel more full and satisfied after eating small amount of food. A patient will now be able to control his/her cravings and hunger.