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Duodenal Switch

It is a method applied on a selected group of patients or on patients who cannot lose weight using other methods. It is an operation that both limits eating and distorts absorption. Efficacy of malabsorption is more than the gastric bypass. It can be performed both with sleeve gastrectomy and the operation that bypasses the intestines.
 
Technique:
 
Operation is performed under general anesthesia using the laparoscopic method or robotic method. The sleeve gastrectomy surgery is performed first. Duodenum separates from the stomach immediately after the outlet of the stomach. The small intestine is measured backwards from bowel and the last 250 cm is cut and then sutured to the stomach’s outlet. The small intestine part where pancreatic enzymes and bile required for the digestion of foods left the stomach is sutured to the part of last 75 cm of the small intestine. Thus, what we eat is passed into the small intestine of 250 cm which was separated from the stomach directly and met with the digestive enzymes at the last part of 75 cm. A serious malabsorption occurs.
 
Advantages:
 
• It ensures better weight loss compared to other methods.
• It ensures to get rid of comorbidities in higher rate.
• It reduced the fat absorption by 70% or more.
• No dumping syndrome is observed.
 
Disadvantages:
 
• It is a more complicated surgery and duration of operation is longer.
• The complication rate is higher.
• Length of hospital stay is longer.
• Vitamin and mineral deficiencies are more frequent.
• Lack of protein may be observed.
• It requires a closer follow-up.
• It is irreversible.
• Bad body odor and foul-smelling stools often occur.