What is Duodenal Switch (Distal Gastric Bypass)?
Duodenal Switch is an advanced obesity surgery technique that provides effective weight loss for individuals with high body weight and works through malabsorption.
In this surgery, the stomach is reduced; however, unlike other surgeries, the stomach is left larger. The stomach is then connected to the lower part of the small intestine. Thus, food passes directly to the lower intestine without passing through the upper intestinal segments, where absorption is intensive.
Basic mechanism:
- The amount of food intake decreases (restrictive effect)
- A large portion of food is eliminated from the body without being absorbed (malabsorption effect)
As a result, even if the person consumes carbohydrates and fats, a significant portion is excreted in the stool without being absorbed by the body.
Who is it suitable for?
- Patients who have previously undergone obesity surgery and regained weight
- Individuals with a high BMI (>50) who need more aggressive weight loss
- Patients with significant metabolic diseases such as diabetes, high cholesterol, and liver fatty infiltration
Warning: This surgical intervention should be preferred for patients who can show both medical and behavioral compliance. The patient must be willing to accept lifestyle changes.
What Are the Advantages?
- It is one of the surgeries with the highest long-term weight loss rates
- It shows strong effects on metabolic diseases like Type 2 diabetes
- It is effective in combating Type 2 diabetes by significantly reducing food absorption
Disadvantages and Possible Complications
- Protein loss may occur due to malabsorption
- Vitamin A deficiency → vision problems like night blindness
- Vitamin B12, iron, calcium, and vitamin D deficiencies → fatigue, bone loss, muscle loss
- Symptoms such as diarrhea, foul-smelling gas, and abdominal pain may affect quality of life
- In severe complications, revision surgery (correction) may be required
Why is it Not Applied to Everyone?
- Duodenal Switch is a more complex surgical procedure with difficult follow-up and high lifestyle requirements.
- For this reason, its application rate worldwide is around 1–2%.
- The selected patient must fully understand both the advantages and challenges of this method.
Goal: Maximum Weight Loss and Metabolic Improvement
Duodenal Switch is one of the surgical approaches that offers the highest success rates in selected patients but requires the best patient follow-up.
An experienced surgeon, a disciplined patient, and a strong follow-up system play key roles in the success of this surgery.
