A number of operations exist to achieve weight loss. Some are termed restrictive procedures which essentially mean that the operation aims to limit the amount of food that can be eaten. Others are termed malabsorptive procedures which aim to reduce the amount of calories the body is able to digest from the food that is eaten.
A sleeve gastrectomy with duodenal switch is an operation which combines these two different surgical approaches to help achieve the best weight reduction results. As such it is normally considered for individuals who are severely overweight and have failed to lose excess weight with lifestyle changes.
A sleeve gastrectomy with duodenal switch is an operation that is performed under general anaesthesia.
The sleeve gastrectomy is performed by the surgeon which involves cutting out the majority of the left side of the stomach. The remaining part of the stomach is then carefully stitched to leave a smaller, more tube like structure in place limiting the amount of food that can be passed in to the stomach at a time.
The duodenal switch involves the entire removal of an organ known as the gallbladder while simultaneously re-routing the tube carrying food away from the stomach (to be excreted) known as the small intestine. The gallbladder normally secretes bile which helps our bodies break down and absorb fat and the small intestine allows the absorption of fats from the food across it’s membrane. As such, this part of the procedure reduces the amount of fat digested by our bodies by as much as eighty per cent.
There are some general risks and complications with any type of surgery which include:
- Anaesthetic risk
- Wound infection
- Blood clots (due to relative inactivity during recovery)
- Nausea and fatigue following the operation
There are also some more specific risks associated with a sleeve gastrectomy with duodenal switch. These can include:
- Deep abdominal infection sometimes leading to sepsis
- Split of the stapled portion of the stomach leading to leakage
- On-going reflux symptoms (heartburn)
- In some patients nutritional deficiencies can lead to osteoporosis, anaemia and other mineral deficiencies
Following a sleeve gastrectomy with duodenal switch, patients will be monitored closely to check for any signs of complications.
Patients will have an all liquid diet for a number of days following the surgery. Where no complications arise patients will then be asked to progress on to a pureed diet for up to three to four weeks after the operation.
Once a solid food diet has been commenced patients will need to ensure that they restrict their intake of fatty foods to a minimum as the body is far less able to process fats following this operation.