Duodenal Switch Surgery

What Is Duodenal Switch Surgery?

Duodenal switch surgery (DS) is a dual-approach weight loss procedure involving a sleeve gastrectomy and surgical bypass.

This operation restricts the amount of food that can be accommodated in the stomach and reduces the number of calories that can be absorbed in the body.

It is a complex procedure, marked as malabsorptive (the intestine does not absorb some of the nutrients consumed in food), so patients must commit to life-long vitamin supplementation and a protein-dense diet.

How Does Duodenal Switch Surgery Work?

The surgery starts with a vertical sleeve gastrectomy. It’s performed laparoscopically (keyhole surgery), and the surgeon will remove approximately 70% of the stomach so it takes the shape of a thin tube or sleeve.

A valve within the digestive tract (pylorus) marks the border between the stomach and the first part of the small intestine (duodenum). Approximately one inch past this border, the duodenum is divided.

An intestinal bypass (Roux-en-Y) is carried out (but usually more bowel is bypassed) to re-establish a channel to food. This surgery means the intestine does not absorb some of the nutrients consumed in food, and so you will need to take extra supplementation for effective nutrition. Our surgeon Mr Simon Dexter advocates bypassing less bowel to reduce the risk of nutritional deficiencies and diarrhoea.

After this procedure, patients can expect to feel fuller sooner. Food is transported to the large intestine in a much shorter period of time, reducing the amount of time available to capture calories from digested food.



*As with any surgical procedure, there are possible risks and complications, including vitamin, calcium and iron deficiencies, protein and fatty acid deficiencies, increased bowel movements or diarrhoea, bleeding, infection, pancreatitis, deep vein thrombosis, internal hernias and death.

These are uncommon and we will do everything possible to prevent them from happening.

Please speak to your Tonic surgeon to discuss the risks in more detail and any concerns you may have.

Weight Loss Results

Of all bariatric operations, the duodenal switch has the lowest rate of weight regain, and patients can expect to lose 90% of their excess weight within two years of surgery.

This procedure also has the best diabetes resolution (more than 90%).

Recovery Time and Aftercare

Patients should expect to stay in hospital overnight and devote at least one week to recovery. Patients can usually return to work within two weeks. Certain activities may be restricted for up to six weeks.

After this extensive intestinal bypass, there is a potential for protein-energy malnutrition, so strict compliance with a high-protein diet is essential to avoid deficiencies.

You should expect vigilant post-operative follow-up and mandatory regular blood tests.

Is Duodenal Switch Surgery for You?

Duodenal switch surgery particularly helps patients with morbid obesity (BMI >60). It is a procedure that results in the greatest overall weight loss and helps to control metabolic conditions such as diabetes.

You must be committed to regular, ongoing aftercare.

Duodenal switch surgery should be used with great caution in designated centres of expertise. Our surgeon Mr Simon Dexter is a leading UK expert in this complex procedure.

To discuss whether this is the right procedure for you, please make an appointment with one of our consultants. They will assess your unique medical needs and explain weight loss options to you.