What to Expect and Results: Duodenal Switch
Duodenal switch surgery is a weight loss surgery that is typically only performed on patients that have had an unsuccessful gastric banding procedure. The surgery is lengthy lasting from three to four hours and the recovery time is substantial compared to other types of weight loss surgery. In some situations the surgeon will perform the operation in two segments.
Advantages of Duodenal Switch Surgery
Because the surgery combines both a malabsorptive approach and a restrictive one, there is an increased rate of weight loss seen. For duodenal switch, Type II diabetics can expect to see a cure rate of 98% and a 92% improvement in sleep apnea cases.
As in all weight loss surgeries recovery time depends upon many factors including the health of the individual, complications that might occur during the surgery, and how well the directions of the surgeon are followed by the patient after the surgery. Recovery for duodenal switch can take three to four weeks before returning to a normal routine and activity. During this time there is typically moderate pain that can be relieved with the help of either over-the-counter medications or prescription pain relievers. Patients can expect their abdomen is sore and tender for several weeks following duodenal switch surgery.
Part of the overall recovery is starting to eat food again after the surgery. In order to avoid putting pressure on the stomach after the stitches or staples have been put in, the food intake is monitored closely. The first week is typically strictly liquid diet regimens. This is followed by a puree of food for about two weeks. When the doctor feels you are ready, soft and small sized food can be introduced. It is important to remember that the stomach size has been reduced and you will feel full faster. Finding the full point is essential and paying close attention to your body will help.
Following surgery, patients should have 90 grams of protein each day. This is because the digestive track needs to be able to absorb the protein properly to avoid a deficiency. For those worried about becoming lactose-intolerant, try eating low-fat or non-fat versions of cottage cheese, milk and yogurt. Some patients may need to take Lactaid, a lactose-free milk.
Patients will need to be taking many supplements including calcium, magnesium, iron, Vitamin A, D, E, K, a multivitamin and a B-complex vitamin. Some patients may experience hair loss due to the stress and nutritional changes in the body following duodenal switch surgery. This is often temporary and changing the vitamin levels back to a healthy level will help to ensure that hair loss stops. Biotin, a vitamin for hair, skin and nails, can also encourage hair growth following surgery.
There will need to be some lifestyle changes made in order to continue to recover. This includes understanding proper nutrition so that the food that you eat is healthy. Since the stomach is smaller you only want to put in food that will be useful to your body. In addition, portion size must be a priority. If you become too full you could start vomiting or have to deal with nausea. In some cases the stomach can become stretched. As a part of the recovery process the individual needs to look at food in a much different way. This can be done best with the help of a nutritionist.
It’s important that duodenal switch patients walk as often as possible and is comfortable for them following duodenal switch surgery. A month following surgery, patients are recommended to walk at least a half hour a day. Do not do any strenuous activity or experience for at least a month and not at all after that time period if it brings you pain.
A patient may drive as soon as they no longer need pain medication to manage their discomfort.
Knowing what to expect as a result of your duodenal switch surgery is an important part of deciding if it is the right surgery for you. While every person is different and the results will vary, the success rate for duodenal switch surgery is good. On average, patients that follow the guidelines set and take an active role in recovery see a 60% loss of excess weight within the first year of the surgery and a 75% loss in excess weight within the second year following the surgery. Some patients have seen 70-80% excess weight loss however, so this shows how each patient may seem a slightly higher success rate than others. However as a whole, all patients see remarkable weight loss success as a result of duodenal switch surgery.
Those with the best weight loss success are those that go through all long term follow up care visits and have made the significant changes to their lifestyle needed in order to maintain a healthy lifestyle. Overall success rates with duodenal switch surgeries are 80%.
Follow up is important as regular blood work and labs are important to avoid any potential risks from nutritional deficiencies commonly seen in duodenal switch patients. According to St Mark’s Hospitals, vitamin B12, iron, Folate, red blood cells and ADEK or fat soluble vitamins should all be checked regularly for optimal health.
Ultimately, excess weight is determined when the current weight is taken of the patient and the healthy weight is subtracted from that total. Professionals use these percentages when discussing weight loss so that they can establish some sort of norm for weight loss expectations. Using the base excess weight number helps them to determine the percent of weight loss.
For example, a patient that starts out at 300 pounds and should be about 154 pounds at a healthy weight can expect a 70% excess weight loss of 102.2. While the numbers will vary depending on the starting weight of the patient and their excess weight will be, it is easy to determine the percentage of excess body weight lost following duodenal switch surgery.
It is important to weigh the options carefully when deciding if duodenal switch surgery is right for you. Your physician will want to make sure you are healthy enough for the surgery and that you are prepared to commit to a lifestyle change after the surgery. This will maximize your chances of success.
Efficacy Associated with Duodenal Switch Surgery
Each type of weight loss surgery procedure provides different results. However, duodenal switch is known for its increased rate of weight loss because of the intense surgery approach, both restrictive and malabsorptive. Many doctors refer to duodenal switch surgery as the most difficult of all weight loss surgery, but it is one that gives patients the most drastic weight loss results. It also has a better chance of long term weight loss success than any other procedure too. It is commonly recommended for patients who have the most weight to lose or have the most comorbidities such as Type II Diabetes, obstructive sleep apnea, high blood pressure and high cholesterol.
Patients who had duodenal switch surgery had the greatest improvements associated with obesity-related conditions (comorbidities). A study reports that an overall total cholesterol decrease of 1.07 mmol/L occurred in DS patients versus just .24 mmol/L with Roux-en-Y gastric bypass patients.
Duodenal switch patients also saw the most dramatic reductions in low density lipoproteins, fat-free mass reductions, fat masses and anthropometrics associated with high cholesterol.
In terms of Type II Diabetes, duodenal switch patients saw major reductions in C-reactive protein reductions and glucose concentration levels. Blood pressure readings also were significantly lower following DS surgery too.
Ultimately, the statistics are clear, duodenal switch surgery has life changing effects on patients who choose to endure the procedure. Not only does the bariatric surgery help reduce weight loss in obese and morbidly obese patients, but also has the highest chance of reducing comorbidity instances in patients more so than other weight loss surgery procedures.