Loop Duodenal Switch Surgery (Loop-DS)
The laparoscopic Loop Duodenal Switch (Loop-DS) is best understood as a combination of two bariatric surgeries.
- The initial part of the surgery involves a sleeve gastrectomy, removing a portion of the stomach resulting in volume restriction, limiting the amount of food that needs to be eaten in one sitting to achieve satiety.
- The second part involves division of the first portion of the intestine just beyond the stomach and connecting this to further down the length of the small intestine, thereby rerouting food so that it bypasses a significant portion of the small bowel. By doing so, it reduces the amount of fat and calories that are absorbed.
Loop Duodenal Switch Advantages:
- Can offer dramatic weight loss results – often up to 80-85% of excess weight
- Good medium for long-term, sustained weight loss outcomes with some studies demonstrating superiority to a gastric bypass
- Helps restrict the amount of food that needs to be consumed to achieve satiety
- Results in malabsorption of calories and fat in consumed meals
- Can resolve or significantly improve obesity-related diseases like Diabetes type 2, high blood pressure, high cholesterol and sleep apnea.
- Potentially an excellent surgery for select patients with inadequate weight loss after a sleeve gastrectomy
Recovery from Surgery:
- Surgery is performed under general anesthesia and takes approximately 2-3 hours.
- After surgery, early mobility, pain control and education regarding a liquid diet are emphasized.
- Most patients are discharged home in 1 to 2 days after surgery.
- Return to work times may vary but many patients return to routine activities in about 1 to 2 weeks.
Safety and Risks:
At New Life Weight Loss Center, a Center of Excellence that does a large number of bariatric procedures each year, the risk of postoperative complications is low. The risk of dying from the surgery is less than 0.2% and the risk of severe complications such as bleeding, infections and thromboembolism is in the 1% range. Bariatric surgery, in appropriate patients, is currently as safe as gallbladder surgery.
However, restrictive and malabsorptive procedures like the Loop-DS can result in significant vitamin and mineral deficiencies including Iron, vitamin B12, vitamin B1, calcium, zinc, folate and fat-soluble vitamins like A, D, E and K. Therefore, as with all bariatric procedures, the patients who undergo Loop-DS require life-long surveillance and vitamin and mineral supplementation. Additionally, acid and bile reflux are potential complications.
Is a Loop Duodenal Switch the right procedure for you?
In general, Loop-DS could be an option for you if:
- Efforts to lose weight with diet and exercise have been unsuccessful and you’re willing to commit to a life-long change in dietary and lifestyle habits.
- Your body mass index (BMI) is 40 or higher (extreme obesity).
- Your BMI is 35 to 39.9 (obesity) and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea.
- It is ideal for patients needing significant weight loss, for those who may not be candidates for a gastric bypass and sometimes as a second-stage operation in select patients with inadequate weight loss after a sleeve gastrectomy.
The information above is intended only as an overview. Whether this surgery is the best option for you or not depends on your specific health history and your goals. During your office consultation your surgeon will take many factors into account, including your BMI, eating habits, your health problems, any previous surgeries and the risks of each procedure and discuss what would be best for you.