Duodenal Switch Surgery in Mexico

Duodenal Switch Overview

Duodenal Switch Surgery

Duodenal Switch Surgery (DS) is a powerful weight loss procedure that reduces the stomach size while rerouting or “switching” the small intestines.

Initially, about 70% of the stomach is removed, causing restriction as the first component of weight loss. This restrictive portion of the duodenal switch creates a new “sleeve-stomach” exactly as the gastric sleeve surgery (VSG).

Next, malabsorption is applied through “switching” the intestines which reduce the time for the digestion process significantly. Through bypassing a large portion of the small intestine, the amount of food, calories, and fat that gets absorbed into the body because of the shortened digestion process is diminished remarkably. This malabsorptive component is similar to gastric bypass surgery and mini gastric bypass surgery.

What is Duodenal Switch Surgery?

The duodenal switch surgery is one of the newest bariatric procedure available. It is gaining popularity because of it’s highest expected weight loss and largest reduction in comorbidities compared to other procedures.

This procedure is known medically as biliopancreatic diversion with duodenal switch (BPD/DS). A significant benefit of the DS procedure is the preservation of the pyloric valve, leaving the bile and pancreatic fluid intact.

There are two weight loss components to duodenal switch surgery:

Restrictive Component

In the duodenal switch procedure, the stomach is made restrictive by vertical division at the larger curvature of the stomach reducing gastric capacity and acid production. The stomach is cut and stapled along the bougie (introduced through the mouth) to form a new stomach with 30% of its original capacity. Removing a large part of the fundus reduces the level of an appetite-stimulating hormone (hunger hormones – ghrelin) and changes the hormonal balance in the GI tract.

Malabsorptive Component

The malabsorptive part of the DS/BPD is performed by creating two limbs:

  • A gastric limb – carries the undigested food
  • A biliopancreatic limb – carries biliopancreatic juices

The “new stomach” is detached from the small intestine* and is “switched” to the last part of the small intestine (3 meters). The other 2.75 meters of the small intestine is bypassed which accounts for the malabsorption part of the DS. This creates a biliopancreatic diversion, which diverts all the digestive juices (bile and pancreatic fluids) from the small intestine that is attached to the new stomach to be mixed at the last part of the small bowel, called common channel (75 cm). The rerouting of the intestine reduces the caloric intake.

* The total length of the small intestines varies from patient to patient, averaging about 6 meters, or 20 feet long.

Changes in Anatomy

The digestive limb, i.e. duodenum and jejunum, is avoided significantly reducing absorption of nutrients and help weight loss. Preservation of the Pyloric Valve in the new smaller stomach prevents marginal ulcers and dumping syndrome experienced by patients with bypass surgery. This surgical treatment of obesity is so potent that most patients with type two diabetes are “cured” before they leave the hospital after the surgery.

Duodenal switch is a viable option for people with significant weight to lose. The DS has the best long-term weight loss results among all of the weight loss surgical procedures.

The super obese patients and patients with a failed sleeve or band surgeries can benefit from this surgery. In the patients with super high BMI, it is recommended that they do DS in two stages. First, the gastric sleeve restrictive stage to lose weight (about 60 to 80 lbs). Second, rerouting the intestines to induce malabsorption and therefore weight loss.

Like gastric bypass, the duodenal switch is restrictive and malabsorptive. The first two parts of the small intestine, i.e. duodenum and jejunum, are bypassed significantly reducing absorption of nutrients and help weight loss. This procedure is so efficacious that 98% of patients with type II diabetes, 70% of patients with high blood pressure and a 75% of patients with high cholesterol are “cured” after the surgery.

Mexico Bariatric Center is at the forefront of Medical Tourism for bariatrics and duodenal switch surgery. MBC represents some of the most qualified surgeons in Mexico. The company has an impeccable track record of patient outcomes and success. If you are curious to learn more about the great benefits our company has to offer, check out this link to see why you should contact us first!

It starts with a form, ends with life changed.

Starts at $6,995 $6,695*

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How Duodenal Switch Works?

AttentionSingle Anastomosis Duodenal Switch (Single Anastomosis Duodeno–ileal Bypass with Sleeve Gastrectomy, SADI-S) is a new type of DS surgery that uses a single anastomosis. In Single Anastomosis DS, there is only one surgical connection between the stomach and the small intestines, as opposed to two in the classical DS. This new procedure is showing promising results.
The duodenal switch has evolved from the biliopancreatic diversion (BPD), which was primarily a malabsorptive weight loss surgery. BDP is rarely performed because of malnourishment issues, which were common.

Duodenal Switch works by using two surgical techniques, malabsorptive and restrictive. This surgery is similar to gastric bypass surgery, yet the DS produces more expected weight loss in three different ways.

1. In a similar fashion to gastric sleeve surgery, 70% of the stomach is cut and permanently removed. This restrictive technique allows patients to feel fuller faster while also reducing ghrelin production.

2. The malabsorptive procedure is when the large portion of the small intestines is rerouted; this to induces fat malabsorption and makes patients absorb roughly 20% of the fat they eat.

3. It also makes changes to the normal way that bile and digestive juices break down food. This cuts back on how many calories you absorb and contributes to more weight loss.

How Do We Perform Duodenal Switch in Tijuana, Mexico?

As a part of the gastrointestinal (GI) tract, the small intestine or small bowel is connecting the stomach to the large intestine. Much of the digestion and absorption of food takes place in here. The small intestine has three regions: duodenum, jejunum, and ileum.
All of our surgeons performing Laparoscopic Duodenal Switch surgery adhere to specific techniques for the highest patient outcomes. The following steps are exercised by MBC surgeons to ensure the highest level of safety for patients.

  • The patient is placed on the surgical table with the face-up and the arms spread apart.
  • The anesthesiologist starts the general anesthesia and inserts a breathing tube into the windpipe.
  • Small incisions (normally 5) are made in the abdomen area to access the abdominal cavity.
  • Trocars are inserted through the incisions as a surgical instrument access port.
  • The abdomen is inflated with carbon dioxide (CO2) gas to create space for surgery.
  • The laparoscope camera is introduced through one of the incisions to view your organs.
  • Small surgical instruments are introduced through ports to perform the surgery.
  • The retractor is used to lift your liver.
  • The first part of the surgery is performed by removing approximately 70% of the stomach, leaving behind a new small sleeved stomach. An Endoscopic Cutter/Stapler cuts and staples the stomach along the greater curvature sized by the bougie inserted through the mouth to form the new stoamach.
    (as explained in the sleeve surgery).
  • The GI tract is diverted beyond the first two parts of small intestine (60% of small intestine), duodenum and jejunum. The small intestine is detached from the new stomach at about 3 cm below the pyloric valve.
  • The final segment of the small intestine (40% of the small intestine called ileum) is attached to the new stomach.
  • Upon completion, the small incisions are closed by dissolvable sutures.
  • The surgeon leaves a drain in the abdominal cavity to detect a leak.

Biliopancreatic Diversion with Duodenal Switch Procedure Explained

The BPD/DS procedure takes about 2.0 to 3.0 hours from start to end. The actual surgery takes about 90 min, depending on the patient's BMI and surgeon’s skills and experience. Mexico Bariatric Center keeps our duodenal switch patients 3 nights in the hospital depending on their condition and overall health. Healing is rather fast, and patients can return to work after two to four weeks following the surgery.

Mexico Bariatric Center (MBC) is one of the pioneering companies to offer duodenal switch surgery in Tijuana, Mexico. In addition to standard laparoscopic duodenal switch, MBC provides the revisional DS. To discover our current pricing for DS in our Tijuana, Mexico Center, please contact our patient care coordinators today. MBC has helped hundreds to get on the loser's bench and change their lives forever.

Arrival
Airport Transport
Hotel
1 Night
Surgery
2.5 Hours
3 Nights in Hospital
Night in Hotel
Recovery
2 to 4 Weeks

Advantages of Duodenal Switch Surgery

  • Duodenal Switch is somewhat reversible; the malabsorptive aspect can be reversed, and then act like a gastric sleeve surgery.
  • Patients can consume a broad range of foods, similar to gastric sleeve.
  • Dumping syndrome is a lot less common, unlike gastric bypass surgery.

Disadvantages of Duodenal Switch Surgery

  • Requires lifelong dietary supplements to combat the malabsorption.
  • The stomach increases in size and does not reverse.
  • Anemia - lack of enough healthy red blood cells or hemoglobin.
  • Gallstones are somewhat familiar with duodenal switch, as with another weight loss surgery.

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Am I a Candidate for Duodenal Switch Surgery?

AttentionThe risk of complications is lower at centers that do more than 100 bariatric surgeries per year (SOURCE: WebMD and MBC Research Study).
The Duodenal Switch procedure is an effectual weight loss surgery that requires a patient with greater life-threatening diseases more than other surgeries. Because of it's high expected weight loss, patients will be necessary these requirements:

  • Patients typically are needed to have a body mass index of 45 or more.
  • Patients with BMI of 35-40 can be candidates for the duodenal switch as long as they have co-morbidities including type two diabetes, hypertension, high blood pressure, or other diseases.

Expected Excess Weight Loss (%EWL)

Duodenal Switch Expected Weight Loss

Diet and Life After Surgery

Distal intestinal bypass in duodenal procedure allows:

  • Patients to absorb 20% of the fat they eat. The failure to absorb fats prevents absorption of the fat-soluble vitamins, such as vitamin A, D, E, and K.
  • Patients to absorb approximately 60% of the protein they eat. Therefore, patients need to consume between 80-120g of protein a day.
  • Patients to absorb 60% of complex carbohydrates and 100% of simple carbohydrates.

The daily supplements after Duodenal Switch procedure are crucial helping prevent nutritional deficiencies. The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends:

  • Vitamin A
  • Vitamin D
  • Vitamin K
  • Multivitamin
  • Iron
  • Calcium supplements and calcium-rich dairy beverages
  • Vitamin B12 supplements
  • Optional B-complex vitamin

You should eat nutritious meals that are high in protein, along with fruits, vegetables, whole grains, and omega-3 fatty acids. You should avoid meals high in sugar.

Cost of Duodenal Switch Surgery

The duodenal switch surgery is the most expensive procedure comparing to the gastric sleeve and gastric bypass. It is a more complicated surgery, and only a small percentage of surgeons can perform this procedure.

Self-pay U.S. patients can expect to pay $24,000 to $32,500. The cost of duodenal switch surgery in Mexico will be considerably less than the U.S. and Canadian counterparts. Most patients will pay typically 1/3 the cost of the cost in the United States. Please contact our staff today to find out our exact cost for duodenal switch. Learn more...

Side Effects, Complications, and Risks

Due to the intestine re-routing, stool tends to be stronger smelling as in the case of gastric bypass. The stool gets loose if the patient consumes too much fat. Consuming too many carbohydrates, fiber, and carbonated drinks may worsen the flatulence.

Learn more about the various surgical hazards, and post-surgery complications after undergoing duodenal switch. Learn more...

* Prices are subject to change. Not valid on blackout dates. Prices depend on the surgeon, surgery, additional fees, and schedule. Prices may rise because of BMI level and previous abdominal surgeries.

** All of the testimonials are covered in our disclaimers. Individuals results will vary; there is no guarantee stated nor implied.

Duodenal Switch Surgical Procedure: Open vs. Laparoscopic

Duodenal Switch surgery can be performed open or laparoscopically. In open (traditional) duodenal switch, a long incision is made in the abdomen area. All open bariatric surgery procedures are no longer performed by surgeons in the U.S. and Mexico.

Laparoscopic surgery is a modern surgical technique that helps faster healing, less trauma to the body and fewer complications. In the laparoscopic duodenal switch procedure, also called Minimally Invasive Surgery (MIS), five small incisions are made in the abdomen.

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Last Updated: January 1, 2018, by Ron Elli, Ph.D.