Are you also someone who suffers a lot from obesity? Maybe you have done nothing to lose weight. Are you tired of exercising, controlling your diet, and doing everything? If so, you must have heard that sometimes doctors talk about weight loss surgeries. We call these weight loss surgeries (`Bariatric surgery`). Today we are going to talk about one such very successful, but also a bit complicated surgery. This is called Duodenal Switch. Don't worry, we will talk about everything very simply.
Simply put, what is this Duodenal Switch?
Duodenal Switch is a surgical procedure performed as a treatment for obesity. It involves two main things. One is to remove a significant portion of your stomach and make it smaller. The second is to shorten the small intestine, the part of your body that absorbs the food you eat.
Think of it this way. It's like taking a shortcut to the food you eat. Then, because the food doesn't travel as far, the amount of calories your body absorbs is reduced. This makes it possible to lose weight very successfully.
There are two main methods of this surgery:
1. Traditional method: `Biliopancreatic Diversion with Duodenal Switch (BPD/DS)`
2. Modified method: `Single Anastomosis Duodeno-ileal bypass with Sleeve Gastrectomy (SADI-S)`
Both of these names may sound a bit complicated, but don't worry. Your doctor will choose the method that is best for you and explain it to you thoroughly.
How does this surgery help you lose weight? Let's take a closer look.
This surgery consists of two main steps. Both steps are performed in the same surgery.
First step: Sleeve Gastrectomy
In this, the surgeon removes about 80% of your stomach. The remaining small part is made into a tube, like a banana. We call this `(Sleeve Gastrectomy)`. After this, you will not be able to eat a lot of food at once. Even if you eat a little, you will feel full. Due to this, the amount of food you eat is automatically controlled.
Step Two: Intestinal Bypass
The next step is to shorten the length of your small intestine. Our small intestine is where most of the nutrients in the food we eat are absorbed into our bodies. In this procedure, the surgeon bypasses the first part of the small intestine and connects the last part directly to the newly created small stomach.
Simply put, once food reaches the stomach, it bypasses a large portion of the small intestine and goes straight to the anus. This greatly reduces the time and space the body has to absorb the calories and nutrients in the food.
It is the combination of these two methods that leads to weight loss. That is:
- The amount you eat decreases.
- The amount of calories absorbed by the body from what you eat decreases.
In addition, this surgery also affects the hormonal system that controls hunger and satiety in our body. As a result, hunger is reduced and we feel full more quickly.
Who is this surgery best suited for?
This is not a surgery for everyone. Doctors recommend this surgery only for people who are at high risk for their health due to obesity. Let's take a look at who is generally eligible for this.
| Eligibility | Description |
|---|---|
| Severe obesity (Class III Obesity) | If your body mass index (BMI) is 40 or higher. (BMI is a measure of whether you are at a healthy weight for your height.) |
| Obesity and other diseases (Class II Obesity with Comorbidities) | If your BMI is 35 or higher, and you have a serious health problem caused by obesity. |
What health problems can be caused by obesity?
- Type 2 Diabetes
- High Blood Pressure
- High blood cholesterol levels
- Heart disease
- Sleep apnea
- Fatty liver disease (Metabolic dysfunction-associated steatotic liver disease)
If you have these types of medical conditions, Duodenal Switch surgery can help you lose weight and also help you control those medical conditions.
What should you do before surgery?
If the doctor decides that you are suitable for this surgery, he will not perform the surgery immediately. Before that, there is a process to thoroughly examine you and prepare you for this.
- Medical tests: Blood tests and ECGs are performed to see if your physical health is at a level that allows you to withstand surgery.
- Getting rid of bad habits: If you smoke or drink alcohol, you will be given advice to stop them completely and treatment if necessary.
- Psychological counseling: This is a big life change. After the surgery, many things in your life will change. Counseling is provided to help you mentally prepare for that change.
- Awareness: Workshops are held to provide a complete understanding of the surgery and how to live afterwards.
- Special diet: A few weeks before surgery, you will be asked to follow a special diet. This involves eating foods that are high in protein and low in fat and carbohydrates.
What are the advantages and disadvantages of the surgery?
Like any surgery, this one has its pros, cons, and risks, and it's important to have a clear understanding of them.
| Advantages | Disadvantages & Risks |
|---|---|
| It can reduce the most weight than other weight loss surgeries. | There is a very high risk of nutritional deficiencies, which requires lifelong vitamin and nutritional supplements. |
| It provides very successful results for people with Type 2 Diabetes. | Frequent bowel movements or diarrhea may occur. |
| You can eat a little more than other surgeries. | As with any surgery, there are risks such as infections, excessive bleeding, reactions to anesthesia, and blood clots. |
| There is less chance of `dumping syndrome` (discomfort that occurs immediately after eating). | Complications such as hernia formation and small bowel obstruction can occur. |
What can you expect after surgery?
You will need to stay in the hospital for a day or two after the surgery. It can take two to four weeks to fully recover. During this time, your body will go through major changes.
In the beginning, you may experience temporary discomfort such as:
- Feeling very tired and exhausted
- Nausea
- Mood shifts
- Hair loss (this is temporary)
- Body pain
- Feeling colder than usual
Don't worry. These are usually temporary. These discomforts will gradually disappear as your body adjusts to this new change.
The most important thing is to stay in touch with your doctor. You will need to go for regular checkups during the first two years, and then have your health and nutritional levels checked periodically throughout your life.
Let's also be aware of possible long-term complications.
Although this surgery is very successful, there are several things to be careful of in the long term.
Malnutrition
This is the main risk . Since your small intestine is less able to absorb nutrients, you are more likely to develop vitamin and mineral deficiencies. So you will need to take vitamin and mineral supplements as prescribed by your doctor for the rest of your life. You will also need to have your blood tested at regular intervals to check your nutritional levels.
Diarrhea
Because food is not digested properly, conditions such as frequent bowel movements or diarrhea may occur. However, if you follow the diet instructions given by your doctor exactly, this can be controlled to a large extent.
Gallstones
When you lose weight quickly, your liver produces more cholesterol, which can accumulate in your gallbladder and form gallstones.
Bile Reflux
Sometimes, due to changes in the functioning of the stomach valves, bile can flow into the stomach.
Your doctor will be monitoring you closely for all of this. So the most important thing is not to panic and to tell your doctor immediately if you have any discomfort.
Take-Home Message
- Duodenal Switch is a very successful and serious surgery for severe obesity. This is not a decision to be taken lightly.
- This surgery not only makes the stomach smaller, but also shortens the digestive tract. As a result, weight loss occurs very quickly.
- The biggest risk of this surgery is nutritional deficiency. Therefore, lifelong vitamin and mineral supplements are mandatory.
- It is very important to maintain a constant relationship with the doctor and undergo regular checkups throughout your life after surgery.
- This surgery is just a tool. The success of the surgery depends on your commitment. Maintaining a healthy diet and an active lifestyle are essential.
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