Gastric Sleeve vs Duodenal Switch
One of the most popular and effective bariatric procedure today is the Sleeve Gastrectomy, otherwise known as Gastric Sleeve Surgery. The gastric sleeve is hands down the top choice for most patients looking to have extremely successful results without having many risks, side effects, or complications.
A more aggressive weight loss procedure is known as the Duodenal Switch Surgery. It is an evolved version of the gastric sleeve, combining two weight-loss components to achieve the greatest expected weight loss.
If you are comparing gastric sleeve vs duodenal switch, here is a complete guide to help find the best surgery for you.
Which Procedure is Best for Me?
The gastric sleeve is used for all ranges of obesity, although it’s a great starter surgery because it is over 80% successful long-term and can be easily revised in the event it fails.
Duodenal switch patients show long-term success with their weight loss and remission of comorbidities, better than the gastric sleeve. As more and more surgeries are performed, surgeons are getting more experienced in the duodenal switch, and its gradually growing as a treatment for severe obesity.
Candidacy Requirements
Do I Qualify for Gastric Sleeve?
BMI 30+
Existing Abdominal Scarring
Previous Ulcer
Committed to Lifestyle Change
Do I Qualify for Duodenal Switch?
BMI 40+
Type 2 Diabetes or Hypertension
Previous Ulcer
Dedicated to Following Strict Lifelong Habits
What is the Biggest Difference?
Gastric sleeve and BPD/DS are done laparoscopically as opposed to open approaches. Both procedures are efficacious in inducing weight loss and improvement in obesity-related conditions. The success of patients losing weight with the less invasive gastric sleeve has caused a gradual decline in the number of DS surgeries.
The duodenal switch is considered the most effective, and most complex weight loss surgery. However, the gastric sleeve procedure provides sufficient weight loss without higher complication rates and side effects.
Weight Loss
Patients with duodenal switch lose more weight due to additional malabsorptive component (refashioning of the small intestine). Research studies at 18-24 months after surgery show that:
- The patients with gastric sleeve lose an average of 60% to 70% of their excess body weight.
- The patients with duodenal switch lose an average of 70% to 80% of their excess body weight
Weight loss with DS patients lasts longer also. Duodenal Switch is mainly reserved for morbidly obese.
Reversal of Obesity-Related Disease
Both surgeries lead to significant weight loss and reversal of obesity-associated conditions. With the duodenal switch, however, the patients tend to achieve a relatively lower BMI than the patients who underwent gastric sleeve surgery. Similarly, there is a higher rate of resolution of comorbid conditions, such as diabetes type 2 (T2DM), hypertension, dyslipidemia, obstructive sleep apnea, osteoarthritis, etc. with duodenal switch vs gastric sleeve surgery.
Table Comparison of Gastric Bypass versus Duodenal Switch
In the past decade, the sleeve gastrectomy is the most widely performed treatment for morbid obesity and obesity-related health issues. Duodenal switch is known as a last-resort procedure for the most severely obese, usually requiring a body mass index of 45+.
Comparing Costs and Insurance Coverage
The costs of gastric bypass surgery range from $5,995 to $19,000 depending on where the surgery takes place. In Mexico, the price is as low as $5,995 and maintains a high-quality procedure. In the United States, self-pay ranges from $15,000 to $30,000 for gastric bypass surgery. Duodenal switch surgery costs anywhere from $6,000 to $35,000 around the world. At Mexico Bariatric Center, we pioneered the duodenal switch surgery in Mexico and have some of the most highly trained surgeons specializing in duodenal switch surgery. Our price is only $7,995.
Duodenal Switch is more involved and more expensive than gastric sleeve surgery. The average cost of the duodenal switch is $29,000 compared to the average price of gastric sleeve surgery of $19,000 in the United States. The cost of both surgeries is lower outside the United States. While some insurance policies cover gastric sleeve surgery, even fewer insurance policies provide coverage for the duodenal switch. Patients undergoing duodenal switch procedures also incur $1500 per year on additional supplements and necessary tests.
Gastric Sleeve vs Duodenal Switch Cost Comparison
Complications and Side Effects
Digestive Tract and Anatomy
The new stomach is like a hot dog or a “sleeve” and has the same shape as the duodenal switch pouch but smaller. With vertical sleeve gastrectomy surgery, there is no anatomical changes, no changes to the pyloric valve, and no intestinal bypass.
The gastric sleeve surgery significantly restricts the volume of food that can be eaten. The mixing of food with bile and pancreatic enzymes occurs as before surgery with no changes. Therefore, there is no malabsorption of nutrients, dumping, or bowel movements.
The new digestive tract after duodenal switch surgery is also changed through both restriction (by resecting about 70% of the stomach similar to gastric sleeve) and malabsorption (bypassing a large portion of the small intestine).
A larger portion of the small intestines is bypassed, or switched, which causes the DS patient to need more vitamins and supplements for their lifetime. The anatomy is more intact, although less protein and fat is absorbed causing more nutritional deficiencies.