The operation method known as a duodenal switch or switch is a surgical operation that combines both sleeve gastrectomy and gastric bypass. In the operation, firstly sleeve gastrectomy is applied and approximately 80% of the stomach is removed. The rest is put into the form of a thin tube and performed in two steps. As a result, the stomach with a volume of 1.5 - 2 liters takes the form of a thin and long tube with a volume of approximately 120 ml.
Then, the small intestine connecting to the stomach is separated to create a bypass, two separate paths and a common canal are created. While the food consumed should normally go to the starting part of the small intestine from the stomach, which remains in the form of a tube after sleeve gastrectomy, it is directed to the lower part of the small intestine. From here, it is provided to go to the colon. This is the short part of the small intestine separated after sleeve gastrectomy. The other way, which consists of the longer part of the small intestine, is the part where bile and other digestive enzymes mix with food and lead to absorption, with the length reduced to 250 cm. As a result, as the stomach volume remains very small, the patient eats less and reaches a feeling of satiety. Since the pathways of the foods in the small intestine are shortened and less absorbed, the amount of calories coming from the food to be used by the body is less.
While this method, which is generally applied to diabetic patients with high body mass index, can be performed with a single operation, it is also possible to be applied gradually according to preference. 6-18 months after sleeve gastrectomy is applied in the first stage, a different operation can be applied for bypass. With this method, patients can lose their excess weight by 70-100%.
Surgical Methods Used in Duodenal Switch Surgery:
Robotic duodenal switch surgery is performed with a few small incisions in the patient's abdomen. The surgeon performs the surgery from the surgeon console, a few steps away from the patient. At the same time, another surgeon who is next to the patient helps the surgeon at the console by including the necessary materials or instruments during the operation. The special camera of the robot provides the surgeon on the console with a real 3-dimensional view of the inside of the patient's body, which can be magnified up to 16 times, and guides the surgeon and nurse next to the patient. The console instantly transmits all the surgeon's movements into the inside of the patient's body in a more precise and sharper way, eliminating hand tremors. The small incisions in robotic duodenal switch surgeries enable the patient to return to his daily life more quickly. But after the surgery patients shoul follow the duodenal switch diet.
Open duodenal switch surgery is performed through a large incision that opened on the patient's abdomen. The size of the incision prolongs the recovery period after the operation. The biggest advantage of open surgery is that the surgeon operates by feeling the tissues.
As in robotic duodenal switch surgery, the operation is performed through small incisions in the patient's abdomen. The surgeon next to the patient operates with long, straight laparoscopic instruments, accompanied by a 2-dimensional image provided by a camera called a laparoscope.
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