Duodenal switch surgery is a weight loss surgery that is usually a two-step procedure. It is used in order to help patients lose enough weight in order to have Roux-en-Y gastric bypass surgery or gastric banding (LAP-BAND) surgery. It is one of the most complex medical bariatric procedures as it combines both a malabsorptive and restrictive approach. The stomach is reduced by 70% and removed (not reversible) and the rest is divided into pathways and a common channel and the small intestine is later rerouted to accommodate these changes. The small intestine changes are reversible.
It is a difficult surgery and requires a significant amount of recovery time compared to the other types of weight loss surgeries. The time for the surgery itself can be between three and four hours. Every recovery time is different based on the individual’s overall health and condition. There also could be complications during surgery requiring a longer recovery time.
Ultimately, recovery time will depend on the overall health of the patient, the complications that may occur as well as the directions given from the surgeon to the patient after their surgery. Most patients that undergo the lengthy surgery can expect anywhere from three to four weeks for recovery, but 4-6 weeks is the optimal healing time (for open surgery types). Those who had duodenal switch surgery laparoscopically, recovery time will be just 1 to 2 weeks (while the new diet will occur for 6 weeks). Even after this recovery time, there is ongoing recovery due to the need for serious lifestyle changes and changes in eating habits. Individuals that go through surgery can expect a fair amount of pain that can be treated with prescription pain medication from the physician.
Pain medications will be needed for at least the first week following surgery and the incision site(s) may be tender or sore. The healing process will occur throughout the new diet plan. For the first month following duodenal switch surgery, the patient’s stomach will only be able to have liquids or soft foods. Patients should remain hydrated throughout the day but never drink before a meal as it will trick the body into thinking your food when you’re just full of liquid. A dietician will work with DS patients in order to devise both a diet plan and a supplement plan.
Also depending on how the patient’s particular duodenal switch surgery was performed, patients will need to avoid strenuous exercise and any heavy lifting to avoid potential leakages or tears at the incision site.
After the surgery individual will need to start getting their body used to food again. This starts with a liquid diet for at least the first week. This allows the stomach to heal from the surgery and offers relief from any pressure that might be put on the stomach during the healing process. After the liquid phase of eating the doctor will have the patient start on a puree of food. This will go on for another week or two depending on how well the patient takes to the new food. The last phase regarding food intake and acclimation is to switch to soft foods and solid foods in small bites.
It is very important that the patient is able to take in the right amount of nutrients without overdoing the portion sizes. The stomach is smaller after the surgery and doesn’t take much to fill. Overeating can cause dumping syndrome with symptoms of diarrhea, nausea, and vomiting. Some patients might experience swelling after surgery that causes them to fail to absorb the liquid. This means that dehydration could follow and the patient may need treatment for it.
As a part of full recovery, the patient needs to understand proper nutrition and portion control. With a smaller stomach, it is important that the food put into the stomach is of use and not wasted food. In addition, it is wise to find your full mark and stick to it. Knowing your body and understanding the signs that will stop you from overeating is very important. You can expect that a good exercise plan will be a part of your overall recovery.
Life changes are an important part of getting back on your feet. While you may be able to return to normal activity after a few weeks, it is important that you understand that lifestyle changes are a major part of your continued recovery after the surgery. Many patients do very well as long as they have a plan and stick to the proper eating habits. Full recovery will take a great deal longer than the few weeks after the surgery completion and will require a lifelong commitment to change.
Ultimately, knowing what to expect as a result of your duodenal switch surgery is an important part of deciding if it is the right surgical procedure for you. While every patient is different and the results will vary in every instance, the overall success rate for duodenal switch surgery is very good. According to recent studies, on average, patients that follow the guidelines set and take an active role in their recovery will see a 60% loss of excess weight within the first year of the surgery and a 75% loss in excess weight in just two years following their duodenal switch surgery.
It’s important to always weigh out the options available when deciding whether duodenal switch surgery is right for your particular health. Your primary care physician and weight loss surgeon can help decide whether or not you’re healthy enough for surgery and if you are prepared enough for the healthy lifestyle commitment following surgery. This commitment will help increase your weight loss success as a whole.