The duodenal switch is considered the most effective bariatric procedure because it results in the greatest amount of weight lost and generally the most dramatic improvement in weight-related conditions, especially type II diabetes.

This procedure is an option for patients with a BMI greater than 50 or in patients with weight gain after a prior bariatric surgery. It is performed in two stages for patients with BMIs greater than 60, as those cases carry higher risk of surgical complications.

The procedure combines elements of a sleeve gastrectomy with an intestinal bypass. Therefore, this an attractive option for those who are looking to lose more weight after a sleeve gastrectomy.

The first step in the duodenal switch procedure is to create a sleeve gastrectomy. This sleeve gastrectomy is slightly larger than a traditional sleeve gastrectomy but still removes a significant portion of the stomach. The next step of the surgery is the creation of the intestinal bypass. This is like the Y-shaped intestinal connection of a gastric bypass, but much farther down the length of the intestine, which therefore drives more hormonal changes, less absorption of calories, and more aversion to high calorie foods.

The procedure typically takes about two hours and most patients go home two days after surgery.

The primary benefit of the duodenal switch is the significant weight loss. However, there are numerous benefits from the surgery, including a 98 percent resolution of type II diabetes, as well as improvements in hypertension, high cholesterol, and sleep apnea.


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