What you need to know about the 'Duodenal Switch' surgery for obesity (Duodenal Switch)

Are you struggling with uncontrollable weight gain, that is, obesity? Are you struggling with diseases like diabetes and high blood pressure? Then you must have heard about weight loss surgeries. Today we are going to talk about one such, a slightly complicated but very successful surgery, the 'Duodenal Switch' surgery. This is not a surgery for everyone, but it is very important to be aware of this.

Simply put, what is Duodenal Switch surgery?

Duodenal Switch is a type of bariatric surgery that involves two main things: one is removing about 80% of your stomach and making it into a small sleeve . The second is reducing the length of your small intestine and shortening it .

These two changes limit the amount of food you can eat and greatly reduce the amount of calories your body absorbs. The result is a significant reduction in body weight. Although this is a less common procedure compared to other weight loss surgeries, it usually results in the greatest amount of weight loss.

There are two main methods for this:

• Traditional method: Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
• Modern method: Single Anastomosis Duodeno-Ileal bypass with Sleeve Gastrectomy (SADI-S)

How does this surgery help you lose weight?

Think of it as a two-step surgery.

Step 1: The doctor removes a large part of your stomach (about 80%). The remaining small part is shaped like a banana, like a tube. We call this `(Sleeve Gastrectomy)`. Because the stomach is small, you cannot eat a lot at once. Even if you eat a little, you will feel full.

Step 2: Next, you'll have an intestinal bypass. The first part of your small intestine is bypassed and the last part is connected directly to the newly created stomach. It's like a shortcut to avoid traffic on the road. This means that most of the food you eat passes through your body undigested. This means that the amount of calories and nutrients your body absorbs from food is greatly reduced .

After this surgery, you eat less and your body absorbs less of the food you eat. Also, this surgery affects your body's hormonal activity. The hormones that control hunger and make you feel full also change, which can help you lose weight.

Who is this surgery recommended for?

This is not a surgery for everyone. It is mainly recommended for those with the highest level of obesity (Class III obesity). Your doctor will carefully examine your health condition and decide whether this surgery is suitable for you or not.

This surgery is usually considered for those who meet the following criteria:

What happens before the surgery?

If the doctor decides that you are suitable for this surgery, you will be referred for a series of tests.

• Routine medical examinations are performed to check whether your health is in good condition.
• If you use tobacco, alcohol, or drugs, we provide the help and treatment you need to stop using them.
• This surgery is a big change in your life. You will be referred for psychological counseling to assess whether you are mentally ready for it.
• You will have to attend seminars to educate yourself about the surgery and how to change your lifestyle afterwards.

Once all of this is complete, you will be given a special diet plan a few weeks before surgery. It includes a diet high in protein, low in carbohydrates, and low in fat.

What are the advantages and disadvantages?

Like anything, this surgery has both advantages and disadvantages.

What happens after the surgery?

After the surgery, you will need to stay in the hospital for one or two days. It will take about two to four weeks to fully recover. During this time, your body will go through major changes.

Temporary symptoms that may occur during recovery:

• Feeling very tired
• Nausea
• Hair loss (this is temporary)
• Body pain
• Feeling cold in the body
• Mood changes

These usually decrease over time.

Long-term complications and management

Because this is a major surgery, there are several things to consider in the long term.

• Malnutrition: This is the biggest challenge. Because your small intestine is not absorbing nutrients well, you will need to take vitamin and mineral supplements for the rest of your life . Your doctor will check your blood periodically to make sure your nutritional levels are adequate.
• Diarrhea: Due to poor digestion of food, stools may become loose and frequent. This can be controlled by strictly following the diet plan given by your doctor.
• Gallstones: Losing a lot of weight at once increases the risk of developing gallstones. You may be given medication to prevent this.
• Bile Reflux: In some cases, bile and blood can flow backward into the stomach.

How will your eating habits change after surgery?

You can't eat normally right away after surgery. You need to give your digestive system time to heal and adjust to the new routine. Your diet will change gradually.

1. Clear Liquid Diet: Things like soup water, unsweetened tea.

2. Full Liquid Diet: Milk, yogurt, liquid soups.

3. Puréed Foods: Foods that have been blended and finely ground.

4. Soft Diet: Things like well-cooked vegetables and soft fish.

All of these steps should be done as per the advice of your doctor and nutritionist. It may take a month or more to get back to a normal diet.

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