Duodenal Switch after Gastric Sleeve Surgery

Duodenal Switch as a 2nd step after a Gastric Sleeve Surgery


Gastric sleeve surgery (VSG) is a very popular procedure that offers great results for many patients but for a % of patients there may be insufficient weight loss or weight regain due to   different reasons, which we will discuss further down. The sleeve is the first step of the Duodenal Switch so for patients that need to lose more weight the natural progression is the  Duodenal Switch, either the traditional DS or the Single Anastomosis DS or SADI-S.

Having a DS as a 2nd step  after a VSG offers the possibility of not only losing additional weight but improving your overall health and keeping the weight off long term. The DS has over 30 years of proven results in the improvement of the following co morbidities:

Diabetes, Hyperlipidemia (elevation of fats in the bloodstream), Hypercholesterolemia (high blood cholesterol), Hypertriglyceridemia (high blood triglycerides) and Sleep apnea.

The restrictive aspect of the DS is basically the same as the VSG. When considering a revision from a VSG to a DS we first check the sleeve via a contrast x ray to make sure the sleeve  was done properly initially, to see if it has overly stretched over time or if it is to remain the same.   When the sleeve needs to be reconstructed it can be done at the same time as the 2nd stage DS.

The main improvement comes from  the malabsorptive aspect of the procedure. Aside from the restrictive and malabsorptive nature of Duodenal Switch, there’s also a metabolic effect, whose improved mechanisms have a positive impact on weight loss and comorbidities. The malabsorptive aspect of the DS is what effectively helps keep the weight off long term. Statistics show that approx 90% of DS patients keep the weight off over a 10 year period, resulting in the best proven weight loss maintenance results of all existing procedures being offered.

The DS, a is procedure that may seem like a result of a combination/alteration of several other bariatric techniques, mainly a sleeve on the upper part and a bypass-like procedure on the lower part. In reality it is a more complex surgery than that. Experienced sleeve surgeons and experienced bypass surgeons do not automatically have the capability or skills to perform the DS safely or properly. While the DS results in more weight loss and greater improvement in comorbidities, the DS’s complexity is linked to higher complication rates if not done under expert and experienced surgeons. Only very few bariatric surgeons have the skills and the credentials to perform the Duodenal Switch. At Mexicali Bariatric Center, Dr. Ungson and Dr. Esquerra  along with Dr Beltran, are the two national authorities on the DS, they are part of the most experienced DS group in all of Mexico with 14 years of experience in the DS procedure.

For the DS surgical team at Mexicali Bariatric Center the Duodenal Switch is not just one more of the services offered for weight loss it is THE main procedure offered.