Duedonal Switch (Biliopankreatik Diversiyon)

Duodenal switch operation is performed in two steps. The first step is to remove 80% of the stomach and shape the remainder into a thin tube. With this process, the stomach, which has a volume of 1.5-2 liters, takes the form of a tube with a volume of 120 ml. In the second step, two separate ways and a common channel are created by separating the small intestine connected to the stomach to create a by-pass. After the procedure applied with these steps, the stomach volume decreases and the patient reaches a feeling of satiety by consuming less food. As a result of this method, the path of the nutrients in the small intestine is shortened, and as a result, the amount of calories remaining from the food is reduced because the nutrients are absorbed less.

WHAT IS DUODENAL SWITCH?

Duodenal switch surgery, also known as switch, is a surgical procedure that combines both gastric bypass and sleeve gastrectomy. The duodenal switch, which is also referred to as biliopancreatic diversion surgery in the medical literature, is a partially volume-restricting and highly absorption restricting surgery.

Duodenal switch surgery is also a surgical option for patients with a body mass index above 50 and for patients who have had sleeve gastrectomy surgery before but have not had a successful outcome. This procedure can also be recommended for patients with uncontrolled diabetes.

HOW DOES DUODENAL SWITCH SURGERY WORK?

Both the reduction in food intake and the slowing down of fat absorption form the basis of weight loss. Therefore, the main effect of this surgery, also known as Biliopancreatic diversion (BPD), significantly shortens the absorption of food intake. With this surgery, a large part of the stomach volume is removed and the volume of the remaining stomach is 200-500 cc. During this surgery, stomach nerves and pyloric valve are preserved. In addition, the intestines are calculated and divided into sections and the relationship of the intestines is rearranged.

SURGERY TECHNIQUES EMPLOYED IN DUODENAL SWITCH:

Robotic surgery (Robot aided minimally invasive surgery)

Robotic duodenal switch surgery is performed by making several small incisions in the patient's abdomen. The robot used in the surgery presents a true 3D image of the patient's interior by magnifying it up to 16 times and transmits the image to the operating room. These real images guide the surgeon and nurse through the surgery. The console used in the surgery controls all the movements of the surgeon, eliminates hand tremor and ensures that the procedures are transmitted to the patient in a sharp instant. Thanks to the small size of the incisions made with this surgery, the patient can return to his routine life much faster.

Open surgery:

With open duodenal switch surgery, a large incision is made in the patient's abdomen. In this surgery, the doctor performs the operation by feeling the tissues. The recovery period in this surgery is slightly longer than in robotic duodenal switch surgery.

Laparoscopic surgery (Minimally invasive surgery):

In the laparoscopic surgery method, the surgery is performed through small incisions on the patient's abdomen, as in the robotic duodenal switch surgery. The surgeon performs the procedure with 2D imaging and long, flat laparoscopic instruments.

Why is duodenal switch surgery preferred?

The reasons for choosing duodenal switch surgery, which is one of the most comprehensive and also statistically most comprehensive weight loss methods in obesity surgery, are as follows:

• Duodenal switch is one of the most suitable methods for diabetes, high blood pressure, high cholesterol and high triglyceride.
• It is helpful in obtaining effective results for patients fed with high calories.
• It does not cause post-operative indigestion problems.
• Due to the removal of the part of the stomach that produces hunger hormone, it leads to a decrease in appetite and hunger.

What are the advantages of duodenal switch surgery?

Duodenal switch, which is one of the preferred methods that help to obtain effective results in obesity surgery; It is a surgery that brings certain advantages. Duodenal switch advantages are as follows:

• It helps to achieve effective results in patients with poorly controlled high triglycerides, diabetes, high cholesterol and high blood pressure.
• Since the pyloric valve of the stomach is preserved and protected, likelihood of complications such as diarrhea, indigestion and alike are greatly reduced.
• It is a suitable method for patients who have a high-calorie diet.
• It helps overweight patients to achieve effective results. However, it is extremely important for the patient to gain healthy habits after surgery.
• It is one of the permanent methods that helps to lose weight in the long term.
• It also helps in solving the problems of breathing, shortness of breath, and lung problems related to obesity.