Duodenal Switch

The Duodenal Switch procedure generates weight loss by restricting the amount of food that can be eaten (due to the removal of part of the stomach - vertical gastrectomy) and by limiting the amount of food (specifically fat) that is absorbed into the body (as a result of intestinal bypass or duodenal switch). Of the procedures that are currently performed for the treatment of obesity, it seems to be the most powerful and effective, but may also be associated with more side effects.

In the Duodenal Switch, the stomach is restricted in size by dividing it vertically and removing more than 85%. This part of the procedure is not reversible. The stomach that remains is shaped like a thin banana and measures 120-200 cc. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while reducing the volume.

The intestines are divided and rearranged to separate food from the digestive juices, thereby also creating malabsorption. This prevents patients who have undergone this surgery from absorbing all of the calories that are eaten.

Who is it suitable for?

Those who pre-operatively have had problems with constipation, something that would probably be made worse by the Gastric Bypass but improved or resolved by the Duodenal Switch
Those who don't like the idea of worrying about dumping syndrome or having a list of foods they couldn't ever have, for example a whole category like sugar
Those people who don’t think they can eat very small quantities for the rest of their life, and if they are confident that they will be diligent about taking supplements and eating sufficient protein

What are the advantages?

Up to 96% of patients see either a cure or improvement in their Diabetes
Up to 90% of patients see either a cure or improvement in their hypertension (high blood pressure)
Up to 80% of patients see either a cure or improvement in their sleep apnoea
Patients experienced reduced pain associated with any Osteo-arthritis
Patients see a reduction in gastric reflux symptoms
Some patients see an improvement in fertility
Normally, digestion and absorption of fat depends on it mixing with bile (produced from the liver and normally entering the duodenum). As this mixing does not occur until much further on in the intestine after a Duodenal Switch, the body's ability to digest and absorb calories from fat is severely reduced. As a result weight drops, even when eating quite normally
Of all the operations, Duodenal Switch is associated with the greatest weight loss (after 2 years up to 80% of patients with a BMI above 50 have achieved normal weight)

What are the drawbacks?

The risks and side effects can also be higher with this procedure than with other operations. Due to the fact that part of the stomach is removed, and the small intestines are divided and re-routed, leakages of gastric contents can very rarely occur causing peritonitis
About 30% of patients can experience problems with offensive wind and diarrhea, resulting from the undigested fat and the upset to the normal balance of bacteria in the intestines. This can be minimised by following a low fat diet
There is also reduced absorption of protein and essential minerals and vitamins such as iron, zinc and Vitamins A, D E and K. As well as taking vitamin and mineral supplements, Duodenal Switch patients need to take double the normal intake of protein in their diet for the rest of their life
Ulcers may develop at the join of the stomach to the intestine
There is a slight increased risk of intestinal obstruction in the long term
Due to the fact that part of the stomach has been removed, the procedure is not reversible

This site has been optimised for Internet Explorer 7

Web design by HTDL

More Information

Less Information

BMI calculator

The body mass index (BMI) is a statistical measurement which compares a person's weight and height. Though it does not actually measure the percentage of body fat, it may be a useful tool to estimate a healthy body weight based on how tall a person is. Due to its ease of measurement and calculation, it is the most widely used diagnostic tool to identify weight problems within a population, usually whether individuals are underweight, overweight or obese. Body mass index is defined as the individual's body weight divided by the square of his or her height. The formulae universally used in medicine produce a unit of measure of kg/m2. BMI can also be determined using a BMI chart, which displays BMI as a function of weight (horizontal axis) and height (vertical axis) using contour lines for different values of BMI or colours for different BMI categories.

Gastric Band

A laparoscopic adjustable gastric band also known as a Lap-Band, is an inflatable silicone device that is placed around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater—or between 35–40 in cases of patients with certain co-morbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, GERD, Hypertension (high blood pressure), or metabolic syndrome, among others.

Gastric Band Surgery

This involves the placement of an adjustable gastric band (made from silicone) that is placed around the upper part of the stomach. It creates a new smaller stomach pouch, with a small opening that leads to the larger part of the stomach below the band. Food pools in the small stomach pouch and creates a feeling of fullness.

The gastric band creates an opening between the smaller and larger stomach. The size of the opening controls the flow rate of food from the two areas. This means the band can be adjusted. To change the size of the opening, the inner surface of the band can be inflated with saline via a port. This is called a fill.

An ideal fill is tight enough to allow a reduction in hunger, increased fullness and cause steady weight loss whilst allowing adequate amounts of food to pass through the band to meet your baseline nutritional needs. People usually require several fills as the band needs very fine tuning to obtain optimum restriction.

Gastric Bypass Surgery

The gastric bypass is a surgical operation that results in enhanced satiety after a small meal. There is a marked reduction in the size of the stomach to a small stomach pouch. None of the stomach is actually removed. The food then passes through the intestine, but the lower part of the intestine is in contact with food much earlier than usual, because as the initial half meter of the intestine has been bypassed.

A side effect of the gastric bypass operation is what is called ‘dumping’, which gives you a light-headed feeling, nausea and occasionally diarrhoea. This happens in response to overeating very sweet foods such as chocolate.

The gastric bypass operation is generally suitable for all patients and achieves excellent results. It is starting to become a surgical ‘treatment of choice’.

Obesity surgery

Obesity surgery, is performed on the stomach and intestine of people who are dangerously obese, for the purpose of losing weight. The two most common procedures are the Roux-en-Y or Gastric Bypass, which closes off a portion of the stomach and bypasses part of the intestine; and gastric banding, which places a band around the stomach. In long-term studies, the procedures cause a significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% to 40%.

Weight loss clinics

Vita Weight Management Clinics are designed to offer the best possible environment to cater for the sensitive needs of those people who are experiencing weight issues. We will be developing clinics in other locations (both NHS and private). If you want to see if we're locating a clinic in your region contact us for further information.
Current clinics:

Birmingham weight management clinic
London weight management clinic
Manchester weight management clinic
Belfast weight management clinic
Ballykelly weight management clinic

Weight loss surgery

Weight loss surgery, is performed on the stomach and intestine of people who are dangerously obese, for the purpose of losing weight.
The two most common procedures are the Roux-en-Y or Gastric Bypass, which closes off a portion of the stomach and bypasses part of the intestine; and gastric banding, which places a band around the stomach. In long-term studies, the procedures cause a significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% to 40%.