Duodenal Switch vs. Stomach Folding2019-01-26T06:53:26+00:00

Duodenal Switch vs. Stomach Folding

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

Stomach Folding

A Lighter Me does not recommend the stomach folding surgery. For a better option, speak with one of our coordinators about a gastric sleeve surgery.

Overview

Stomach folding, also known as gastric plication, is a relatively new procedure that is considered experimental and is performed laparoscopically. It is a minimally invasive surgery, and it usually takes just about an hour to complete. During the procedure, the surgeon makes five small incisions in the abdomen in order to reach the stomach. The surgeon then folds the stomach into a smaller, more compact size, typically reducing its volume by about 70 percent. Depending on the size of the stomach of the patient, the surgeon will do one or two folds, and the folds will be held with non-absorbable sutures. This surgery is potentially reversible, so if the stomach needs to be returned to its original size for any reason, that will most likely be possible. With a smaller stomach, patients typically feel fuller faster, and they often have a decrease in appetite as well. This surgery does not usually result in any severe food restrictions. With surgery and lifestyle changes, many patients are able to reduce or eliminate their need for blood pressure, diabetes, and depression medications.

Patient Eligibility

In order to be eligible for this surgery, individuals must have a BMI of at least 27. The ideal candidate will have a BMI of 40 or more, or they will have a BMI over 35 with at least one weight-related health problem.

Average Weight Loss Results

Patients can typically lose 2 pounds per week after the completion of this procedure. In total, most patients lose between 40 and 60 percent of their excess body weight within a year.

Recovery Time

Patients often must stay in the hospital for a day or two after the surgery, but within a week, they can usually return to work. Full recovery takes about 4 weeks. The first 2 weeks after surgery, the patient is required to consume an all liquid diet. The patient will then be able to add in thicker liquids, yogurt, and fruit. Eventually, regular foods can be consumed, but most people are only able to eat up to four spoonfuls of food per meal.

Common Side Effects

The most common side effects are nausea and vomiting, but oral medication can be given to minimize these effects. Even without medication, these side effects typically disappear within a week.

Cost

The average cost of stomach folding is approximately $10,000 to $15,000. Insurance does not typically cover this procedure.

References:
https://health.ucsd.edu/news/releases/Pages/2012-03-09-stomach-origami.aspx