Surgical Technique
Duodenal switch (DS) is an effective metabolic surgery method used in the treatment of severe obesity. This minimally invasive procedure is performed laparoscopically through 5-7 small incisions.
The surgery consists of two stages:
- Removal of 70-75% of the stomach, creating a tube with a volume of 150-200 ml
- Diversion of 200-250 cm of the small intestine and duodenal anastomosis
This technique reduces the daily calorie absorption to 1,200-1,500 calories.
Clinical Outcomes
DS surgery is preferred, especially in patients with a body mass index (BMI) over 50. The rates of metabolic improvement are quite high:
- Remission of type 2 diabetes: 98%
- Normalisation of blood pressure: 95%
- Improvement of sleep apnoea: 92%
- Normalisation of blood lipids: 90%
Weight Loss and Follow-up
Patients lose 35-40% of their excess weight in the first 6 months, and 75-85% in 18-24 months. The nutrition programme gradually progresses from liquids to solid foods over the first 8 weeks.
Vitamin Supplementation
Daily required supplements:
- ADEK Multivitamin (twice a day)
- Elemental iron (18-27 mg)
- Calcium citrate (1,500-2,000 mg)
- Vitamin B12 (1,000 mcg/month, injection)
Regular blood tests are required every 3 months in the first year, and every 6 months thereafter.