Laparoscopic Duodenal Switch is one of the most complex laparoscopic weight loss procedures. It provides with the best weight loss results as well as the best long-term weight control. Average excess weight loss is about 75% - 80% and the average long-term excess weight loss is about 75%. However it carries a higher risk than the other procedures and the risk for malabsorption is high if the patient didn’t follow the guidelines. These patients need life long physician follow up.

There are very few surgeons in the world performing this procedure especially using the laparoscopic approach. Our practice is the first in the state of Texas to offer this procedure utilizing the laparoscopic approach.

Steps:

In the first step a vertical Gastrectomy is performed. The new stomach consists of a very narrow and long tube without the reservoir capacity. This stomach tube is continuous with the esophagus above and the small intestine below. The remainder of the stomach is removed permanently.

In the second step the intestine is divided at two places. Once one inch below the stomach outlet / duodenum and the second is at 8 feet measuring backwards from the small intestine-colon junction. An intestinal bypass is performed to create separate channels of intestine for food and digesting enzymes. Once these two channels meet there is only a 100cm long intestine for food digestion and absorption.

The advantages are that the stomach outlet is controlled naturally with very low chance of ulcers in the stomach and there is no dumping. The disadvantages are higher complication rate and some offensive body odor related to fat malabsorption. This may be reduced by dietary modification and some medications as needed.