What is Duodenal Switch Surgery?

The duodenal switch, also known as the biliopancreatic diversion with duodenal switch or DS for short, is a complicated and less commonly performed procedure. The duodenal switch weight loss surgery is a combination of the gastric sleeve and gastric bypass and is non-reversible.

How it works

First, a smaller, tubular stomach pouch is created by removing a portion of the stomach, very similar to the Sleeve Gastrectomy. Next, a large portion of the small intestine is bypassed. The duodenum, or the first portion of the small intestine, is divided just past the outlet of the stomach. A segment of the distal (last portion) small intestine is then brought up and connected to the outlet of the newly created stomach, so that when a patient eats, the food goes through a newly created tubular stomach pouch and empties directly into the last segment of the small intestine. Roughly three-fourths of the small intestine is bypassed by the food stream. The bypassed small intestine, which carries the bile and pancreatic enzymes that are necessary for the breakdown and absorption of protein and fat, is reconnected to the last portion of the small intestine so that they can eventually mix with the food stream.

Advantages of Duodenal Switch Surgery

Patients who have gastric sleeve surgery can expect to lose 80 to 100% of their excess body weight within the first year.


Improvement in overall health and quality of life. It is the most effective weight loss surgical procedure.

It is not an ulcerogenic procedure; patients can resume taking their usual anti-arthritic medications after they have recovered from their surgical procedure.

Improvement or resolution of serious medical conditions.