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An Approach to Duodenal Switch
The United States Institutes of Health recommends bariatric surgery for individuals with a BMI 40 or greater. Such individuals are considered seriously obese and can develop life threatening health risks, including cardiovascular failure, diabetes and stroke to name a few.
Bariatric surgery is designed for patients who are obese to the point that they may be a high health risk. Designed to reduce the volume of the stomach by altering the stomach through a number of methods such as removal, stapling and restriction, bariatric surgery reduces the digestive capacity of the stomach so that fewer calories are consumed. Fewer calories digested results in weight loss.
The most complicated form of bariatric surgery is the duodenal switch operation. Approaching obesity from two different paths, the duodenal switch operation reduces the size of the stomach, by removing a long section. The stomach is shaped like a large hand bag, but after surgery the stomach looks like a banana. The reduction in size reduces the total amount of food that can be processed by the stomach.
Following the stomach size reduction, the exit of the stomach is removed from the top of the small intestines to the large intestines. Altering the path of digestive system results in food bypassing the small intestines where digestion begins. Entering the large intestines, food is not digested entirely and passes out of the intestines. Overall, a duodenal switch operation results in significantly fewer calories being digested.
Improved weight loss after a duodenal switch typically results in additional surgical procedures such a lap band surgery. Lap band surgery does not alter the size of the stomach, but does affix a band around the top of the stomach to restrict food intake. Saline or silicone are injected into the ring to restrict the ring around the stomach. After surgery, patients visit a surgeon periodically for a lap band fill to increase the lap band’s restriction. These “fills” help continue the positive results of weight loss for the patient.
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