Duodenal Switch Surgery

A Proven Solution to Reach Your Weight-Loss Goals

If bariatric surgery is the best next step in your weight-loss journey, we’ll help you consider all your options, including a duodenal switch procedure, to find what’s right for you. We offer the duodenal switch surgery as a proven, safe and transformative solution for those struggling with obesity. This weight-loss procedure combines two effective strategies, helping people achieve long-term weight loss and improve their overall health. Our team is dedicated to providing personalized care and supporting you throughout your weight-loss journey.

What Is Duodenal Switch Surgery?

Biliopancreatic diversion with duodenal switch (BPD-DS) is a bariatric surgery that helps with weight loss. Because it can help people reduce their weight by 60 to 85%, it’s considered a great option for people who have severe obesity and need to lose weight for health reasons.

BPD-DS is a more complex procedure than other bariatric surgeries. This is because it's actually a combination of two surgeries: a sleeve gastrectomy, which removes about 80% of the stomach to create a small pouch, and an intestinal bypass, which removes the upper portion of the small intestine and attaches the remainder to the new stomach pouch.

The combination of these two surgeries creates a new digestive system that greatly restricts the amount of food you can eat and how many calories and nutrients are absorbed by the body.

Benefits of Duodenal Switch Surgery

The biggest benefit of BPD-DS is significant weight loss. Most people can expect to lose between 60 to 85% of their starting weight within the first two years after surgery.

Other benefits of BPD-DS include:

  • Altering gut hormones to reduce appetite and keep you feeling fuller, longer
  • Eliminating gastroesophageal reflux disease (GERD)
  • Eliminating high blood pressure
  • Enhanced metabolism
  • Improved blood sugar control
  • Lower cholesterol levels
  • Managing Type 2 diabetes
  • Reduced ulcer risk
  • Resolved sleep apnea

Is Duodenal Switch Surgery Right for You?

Just like all types of weight-loss surgery, BPD-DS isn’t right for everyone. Duodenal switch is normally prescribed for patients who:

  • Have a BMI of 50 or higher (severe, or class III, obesity)
  • Have a BMI of 40 or higher and a major obesity-related health issue

Examples of major obesity-related health conditions include:

  • Heart disease
  • High blood pressure
  • High cholesterol
  • Nonalcoholic fatty liver disease
  • Sleep apnea
  • Type 2 diabetes

If you decide to pursue weight-loss surgery, your AdventHealth bariatric surgeon will evaluate your health and discuss your options.

You may not be a candidate for BPD-DS if you:

  • Are under 18 years of age
  • Have a preexisting digestive issue, such as irritable bowel syndrome
  • Have a preexisting nutritional deficiency disorder, such as chronic anemia
  • Use steroids
  • Have a substance use disorder
  • Can’t commit to restrictive dietary modifications and a healthy lifestyle for the rest of your life

The Duodenal Switch Surgery Procedure

Before the Procedure

Although BPD-DS is a major surgery, it’s minimally invasive as it is normally performed laparoscopically. Compared to conventional surgery, minimally invasive procedures often mean smaller incisions, less pain and scarring and a faster recovery. Your surgeon and care team will walk you through how to prepare for your procedure well before the day of your surgery so that you know how to prepare and what to expect.

During the Surgery

During the surgery:

  • An anesthesiologist will administer anesthesia so you stay asleep during the surgery.
  • First, your bariatric surgeon will remove about two-thirds of your current stomach.
  • The surgeon creates a pouch or sleeve — your new stomach — from the remainder of your original stomach, which can hold between three and six ounces of food at a time.
  • Last, your bariatric surgeon divides your small intestine and attaches the now-reduced small intestine to your new stomach pouch.
After the Procedure

Once your procedure is finished, your surgery team will move you to a recovery room for observation as you come out of your anesthesia. Every person is different, but in most cases, patients stay at the hospital for two or three days post-surgery and then are allowed to finish their recovery at home. Most patients can return to normal activities within two to four weeks after surgery.

Why Choose AdventHealth for Your Duodenal Switch Surgery?

At AdventHealth, our Surgical Weight-Loss Program offers experienced bariatric surgeons and state-of-the-art surgical facilities. Your entire weight-loss surgery team will be at your side, delivering comprehensive care before and after your surgery. Our vital support programs help you lose weight and keep it off.

If you’re ready to start your bariatric surgery journey, contact your nearest AdventHealth bariatric surgery center today.

Answering Your Questions About Duodenal Switch Surgery

  • How is duodenal switch surgery different from gastric bypass?

    Both biliopancreatic diversion with duodenal switch (BPD-DS) and gastric bypass are types of bariatric surgery. However, there are some main differences in what happens during the surgery. During gastric bypass, your bariatric surgeon creates a small pouch from your original stomach and reroutes your small intestine, which helps suppress the amount of food you can eat and how many calories and nutrients are absorbed by the body. BPD-DS also creates a stomach pouch and redirects the small intestine; however, it bypasses a larger portion of the small intestine, helping to provide greater weight loss.

  • How much weight can I expect to lose after the surgery?

    Patients can expect to lose between 60 and 85% of their starting body weight within the first two years of surgery. Normally, post-surgery patients experience a rapid weight loss during the first three months, which then becomes a slower, steadier weight loss for the remaining 12 to 18 months.

  • How long does the surgery take, and what is the recovery time?

    BPD-DS surgery usually takes between three and four hours to complete. And patients generally stay in the hospital for two to three days before being discharged to continue their recovery at home.

  • Will I need to follow a special diet after surgery?

    Yes. Immediately following surgery, you will be placed on a clear liquid diet for about seven days. From there, your bariatric surgeon will allow you to transition to thicker liquids, such as protein shakes, and then on to soft solid foods. Everyone is different, so your post-surgery diet may look different from others.

    Then, for the long term, with your new stomach pouch only able to hold three to six ounces of food, your diet will need to be more focused on high-protein, nutrient-dense foods, and we suggest changing your eating pattern to six to eight smaller meals throughout the day.

  • Can duodenal switch surgery improve conditions like Type 2 diabetes?

    Yes. This is why BPD-DS is generally considered the best bariatric surgery option for people who have severe obesity and Type 2 diabetes.

  • Is the surgery reversible?

    No, it is not fully reversible. While the rerouting of the small intestine can be changed, the stomach pouch cannot be reversed.

  • What kind of follow-up care does AdventHealth provide?

    Your AdventHealth bariatric surgery team is with you every step of the way, from your first surgery consultation to providing support throughout your lifelong post-surgery weight-loss journey. All patients are required to follow up with their surgeon within two to three weeks after hospital discharge, followed by visits at six weeks, three months, six months and one year. From there, depending on your situation, surgery patients are asked to come in for follow-up appointments every six months to every two years.

    In addition to follow-up care with your surgeon, your AdventHealth bariatric surgery team includes a variety of specialists to help you on your journey, including registered dietitians, mental health professionals and exercise physiologists to help ensure you're eating right, getting enough exercise and are in the right mental space to be successful for the long term.

  • How do I prepare for duodenal switch surgery?

    If your AdventHealth bariatric surgeon believes BPD-DS is right for you, they will provide you with a full checklist of what to do before your surgery and what to expect after. You will be asked to switch to a liquid-only diet a few days before surgery, and you may also have to adjust some medications you're taking. Your surgeon will order some medical tests to be done before surgery, and may also ask you to make some lifestyle changes, such as quitting smoking or starting an exercise program.