Duodenal Switch vs. Implantable Gastric Stimulation2019-01-26T06:53:26+00:00

Duodenal Switch vs. Implantable Gastric Stimulation Device

Duodenal Switch

A Lighter Me does not recommend the duodenal switch procedure. A gastric sleeve operation is more affordable and often has less complications.

Overview

Duodenal switch surgery combines a sleeve gastrectomy and an intestinal bypass. During this procedure, approximately 60 to 70 percent of the stomach is removed; this results in the stomach forming into the shape of a tube. After that, two thirds or more of the intestine is bypassed, which leaves only a few feet inside the intestine where digestive enzymes and food can meet; this causes malabsorption. After surgery, the body will be unable to absorb a majority of the calories and nutrients that are eaten, so very high weight loss often occurs. This procedure got its name because the duodenum, the first part of the intestine, is divided and attached to the lower section of the small intestine. The pylorus, the outlet muscle that controls the emptying of the stomach, is preserved during this surgery; this often results in dumping syndrome. This surgery has been shown to result in the most reliable and longest lasting results of all weight loss procedures.

Patient Eligibility

Good candidates for this surgery have a body mass index (BMI) greater than 40. Individuals with lower BMIs may still be eligible for this procedure if they have weight-related medical problems.

Average Weight Loss Results

Most patients lose between 60 and 80 percent of their excess body weight over a 2-year period. Ten years after surgery, most patients have shown to still have a total weight loss of approximately 70 percent.

Recovery Time

The average recovery time is between 3 and 4 weeks.

Common Side Effects

After duodenal switch surgery, patients often experience decreased absorption, which causes more frequent and looser bowel movements and increased flatulence. Patients should also be closely monitored for vitamin, mineral, and protein deficiencies, due to the decrease in the absorption of nutrients.

Cost

Most insurance companies will not cover this surgery, and it can cost as much as $20,000.

References:

http://www.columbiasurgery.org/conditions-and-treatments/duodenal-switch-bpd-ds

Implantable Gastric Stimulation Device

Overview

Implantable gastric stimulation is a relatively new way to treat obesity. It does not change a patient’s anatomy or rely on malabsorption issues for weight loss, and it takes less than an hour to complete. It is also reversible. Using a laparoscopic approach, a device that is an electrical pulse generator, similar to a pacemaker, is implanted along the front part of the abdomen. Electrode leads are then placed in the gastric muscular wall. Once the surgery is complete and the patient has recovered, the device will be turned on, and the gastric stimulation will begin. The purpose of the device is to make patients feel fuller faster, which may help with overeating and binge eating. It is believed that when the device stimulates the stomach, a message is sent to the brain telling it that it is full.

Patient Eligibility

The ideal candidate for this procedure has a BMI over 40 or a BMI between 35 and 40 plus serious weight-related health problems.

Average Weight Loss Results

Since this is a relatively new procedure, there is not a large amount of data available regarding weight loss results. In general, it appears that patients typically lose between 5 and 17 percent of excess body weight from implantable gastric stimulation. It has been reported that some patients did not lose any weight and others actually gained weight after this procedure. Approximately 80 percent of patients have reported some weight loss, and 60 percent lost more than 10 percent of their body weight within 2 ½ years. In general, it appears that diet and lifestyle changes are necessary for weight loss to occur.

Recovery Time

Most patients are given approximately 4 weeks to recover from the procedure. Once the recovery is complete, the stimulation will begin.

Common Side Effects

Possible side effects from this procedure include abdominal pain, generalized pain, fever, and flatulence. Nausea, constipation, and hypoglycemia may also occur, but they are relatively rare.

Cost

The cost of this procedure varies, but it is likely to fall somewhere around $15,000 in the US. Insurance may or may not pay for a portion of this procedure.

References:
https://commons.pacificu.edu/cgi/viewcontent.cgi?article=1242&context=pa