Duodenal Switch is a surgical technique for weight reduction and comorbid diseases control; It is the most laborious of all bariatric procedures so far, it involves performing a Vertical Sleeve Gastrectomy and a Y-Roux Bypass to the duodenum. With this technique, a 70% to 100% of excess weight is lost in a long term, improving all comorbidities and reaching a 95% to 97.9% metabolic regulation of dyslipidemia and diabetes. Notorious changes can be seen since the first week of a Bariatric Surgery of Duodenal Switch. This surgery, which must also be done through minimal invasion, requires five to seven incisions, so six are usually done.
How does the patient benefit from a Duodenal Switch?
It works through two mechanisms:
1.- Restrictive component: reduction of gastric capacity by 75%. 2.- Malabsorptive: the exclusion of the duodenum and the proximal jejunum from the transit of nutrients prevents the secretion of a signal that promotes insulin resistance that leads to a Type 2 Diabetes Mellitus. It stops absorbing a significant amount of fat.
Complications of Duodenal Switch When presented, these are correlated to the BMI of each patient, being up to 24% in patients with a BMI greater than 50 and 14% in patients with a BMI lower than 50. Whether they are early or late complications, most of them are metabolic in nature and easily controlled, achieving a good satisfaction index, with a mortality rate not higher than 1.5%.
- Post-incisional hernia: less than 5%
- Intrabdominal abscess: 6.8%
- Intrabdominal bleeding 2.4%
- Leakage: between 1.6-1.9%
- Stenosis: 1.5%
– Las derivadas de la malabsorción nutricional.
Postoperative Diet - Nutrition Duodenal Switch
The oral intake begins 24 hours postoperatively, if there was no evidence of leakage in the study of contrast medium. The diet is similar to a Gastric Sleeve or Gastric Bypass regimen: four stages for six weeks, with a progressive volume from 30 cc to reach 150 cc, without changing the quality of the food. The patient will start with clear non-caloric drinks, decaffeinated and non-carbonated liquids (three days). Progressing to full liquids for 14 days. This diet contains high biological value proteins (25-30 gr.). The third phase contains soft foods or purees (crushed food) for the following three weeks: 90 cc to 120 cc, five to seven times a day and a protein goal of 60 grams. And the last stage is conformed with three small meals and two or three snacks; solids, fats and low sugars are prohibited. The following nutritional supplements should be taken: iron 300 mg, calcium 500 mg, vitamin D 50,000 Ud, vitamin A 20,000 Ud and a multivitamin daily.
Empezamos con bebidas claras no calóricas, líquidos descafeinados y no carbonatados (tres días). Entonces progresamos a líquidos completos durante catorce días. Esta dieta contiene proteínas de alto valor biológico (25-30 g). A continuación, pasamos a la tercera fase, puré o suave (alimentos triturados), para las tres próximas semanas: 90cc a 120 cc, cinco a siete veces al día y una meta de proteína de 60 gramos. Y la última etapa con tres comidas pequeñas y dos o tres bocados que no sean sólidos, ni contengan grasas o azúcares bajas.
Se deben de tomar los siguientes suplementos nutricionales: hierro 300 mg, calcio 500 mg, vitamina D 50.000 Ud, vitamina A 20.000 Ud y un multivitamínico diariamente.
Nutrients’ Control and Monitoring
Nutrients should be evaluated every 3 months during the first year:
- Blood proteins.
- Calcium metabolism: calcium, vitamin D, and PTH.
- Hematological evaluation: hemoglobin, serum iron, ferritin, folic acid, vitamin B12.
- Liver function: ALT, AST, alkaline phosphatases and bilirubin.
- Liposoluble vitamins: A, E and K.
Quality of life after a Duodenal Switch
95% of the patients who underwent Duodenal Switch surgery feel very satisfied, since they significantly improve activities of their daily life such as: personal acceptance in their social life, personal hygiene, walking, climbing stairs, self-confidence, marital and sexual relationship, as well as a very remarkable improvement in areas such as a change of appetite, vomiting, abdominal problems, the type and characteristics of the stools.
WHAT IS INCLUDED:
• 2 hospital nights.
• Medical fees.
• Medicines inside the hospital.
• Nutrition consultation after surgery (1 and 2 of nutrition and / or one month of follow-up).
• Psychological assessment + 1 consultation (stage 1 and 2 of Psychology) / or one month of follow-up.
• Stay of a companion in the facilities of the hospital.
WHAT IS NOT INCLUDED:
• Extra charges due to complications or extra non-standard tests additional to the package offered.
• An additional charge applies to patients with a BMI (Body Mass Index) greater than 50, which is considered high risk.
DEPOSIT AND PAYMENT OF THE SURGERY:
Once your appointment for surgery is confirmed, the hospital will require an initial refundable deposit to reserve the date suggested by you and the balance will be reimbursed.
Recommended hotels (not included in the surgery price)
• HOTEL EJECUTIVO EXPRESS WEB HERE
• HOTEL LA ESTANCIA TAPATÍA WEB HERE
• HOTEL CITY EXPRESS PLUS WEB HERE
* Previous approved surgeries.
*Previo depósito requerido para confirmar la cirugía.