What Is Loop Duodenal Switch Surgery?
The loop duodenal switch (SADI-S) is a recent safe and highly effective modification of the historic duodenal switch (DS) procedure, also known as biliopancreatic diversion with duodenal switch (BPD-DS).
Like the gastric bypass, SADI-S is is both a malabsorptive and restrictive surgery. Restrictive means that the stomach is reduced in size, which restricts the amount of food that you can eat. Malabsorptive surgeries reduce the amount of nutrients that your body absorbs, in this case by reducing the size of the small intestine. The combination of malabsorption and restriction makes loop duodenal switch surgery, like other bariatric surgeries, extremely effective at enabling our patients to lose weight and keep it off*.
How Is Duodenal Switch Surgery Done?
This surgery involves removing about 85% of your stomach by forming a sleeve gastrectomy on top. This reduces the amount of food that you can consume at one time. In addition, just after the sleeve portion, the first portion of the small intestine immediately after the stomach is divided and brought in a loop of small intestines up to the stomach to bypass about half of the small intestines. This reduces the amount of calories that can be absorbed (as well as the amount of fat) even more than the bypass.
How Is Today’s Loop Version Different From Traditional DS?
The traditional procedure, called the biliopancreatic diversion with duodenal switch (BPD-DS) or the gastric reduction duodenal switch (GR-DS), involved bypassing more than 80% of a person’s small intestines. While this operation led to high weight loss, a subset of patients suffered persistent vitamin or protein malnutrition in spite of supplementation. This was because too much of the small intestine was bypassed, limiting patients’ ability to absorb crucial vitamins and proteins.
Today we do a loop DS version of this operation (SADI-S) that bypasses only about half of the small intestine. Leaving this amount of intestinal length to absorb nutrients minimizes a person’s risk of vitamin or protein deficiencies while maximizing weight loss in a safe setting*.
However, if you are considering this operation as a way to cure type II Diabetes or maximize your weight loss opportunity long-term, you must be very committed to perfect compliance in taking a certain set of vitamins and protein every day for the rest of your life. This is crucial to help you maintain adequate healthy vitamin and protein nutrition. With (and only with) this commitment, the SADI-S operation has been shown to be safe and very effective*.
What Should I Expect From Duodenal Switch Surgery?
The primary advantage of loop duodenal switch (SADI-S) surgery is that it combines intake restriction (the sleeve portion of the surgery limits the amount of food you can eat) with substantial calorie malabsorption (the rerouting of the intestines reduces absorption of fat and calories). This results in the highest percentage of unhealthy weight loss with the lowest risk of significant weight regain*. Patients on average can expect to lose 80-100% of their unhealthy weight over about 9 months*.
Another significant advantage of the loop duodenal switch is that this operation is very good at resolving obesity-related health problems such as high blood pressure, obstructive sleep apnea, and high cholesterol*. It has the highest success rate of any bariatric surgery in curing Diabetes II*.
What Is Duodenal Switch Surgery Like?
Surgery takes approximately one and a half hours. This will vary based on your past surgical history and anatomy. The typical hospital stay is two nights.
This procedure is almost always done laparoscopically through five small incisions in the abdomen. Laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures.
How Much Pain Will I Have After Surgery?
Any surgical procedures can be painful. However, at the BMCC we utilize a variety of strategies to minimize pain and in some cases even take away your pain completely. One technique that we have pioneered for our bariatric patients is the use of a TAP block. This uses a long-acting anesthetic that dramatically reduces post-operative pain and the need for pain medication*. In fact, after a TAP block, some patients never need any additional pain medication.
What Kind of Follow-Up Will I Need After Surgery?
After surgery it is vital to follow up with our office. You will be asked to come in for a post-operative visit with the surgeon two weeks after surgery and then a visit with the team at 6 weeks, 3 months, 6 months, one year, 18 months, and annually thereafter. Patients who follow up regularly usually do the best at losing weight and keeping it off.
Is SADI-S Surgery Right For Me?
You may be a good loop duodenal switch (SADI-S) candidate if you:
- Have a BMI > 50 or are interested in losing 80-100% of your excess body weight*
- Want your best chance of curing type II diabetes (up to 98%)*
- Know that you will be extremely dedicated to a life of vitamin and protein supplementation
You may not be an ideal loop DS candidate if you:
- Have current vitamin or mineral deficiencies (including anemia)
- Suffer from Crohn’s disease, a medical condition requiring prednisone or anti-inflammatory medications; or have had many previous abdominal operations
- Struggle with irritable bowel syndrome with frequent diarrhea as the DS can be expected to increase the softness and frequency of your stools
- Have severe reflux (the sleeve portion has been shown to increase reflux after surgery in up to 20% of patients)
Duodenal Switch Surgery Testimonials
“We were set free and it feels better then any dream or fantasy you could imagine, because it is real and continues to get better everyday! We fit in any booth, chair, seat there is and for me that is something I have never felt in as long as I can remember. We are currently planning a huge family vacation and we can’t wait to go on the plane and be able to sit in the seat comfortably. We owe our new lease on life and our amazing new health to The Bariatric Center, Doctor Long, and the entire staff who has brome not only great mentors and coaches, but true friends and life long partners. We are forever grateful and proud to be a part of Doctor Long’s family of success!”—Lisa and Chris Chesrown, duodenal switch patients.
If you or a loved one has further questions or would like more information about the loop duodenal switch (SADI-S) or other surgical or non-surgical weight loss, please check out our FREE ONLINE SEMINAR or REGISTER FOR A LIVE SEMINAR today.