The duodenal switch (DS) Surgery is also known as biliopancreatic diversion with duodenal switch (BPD-DS) or gastric reduction duodenal switch (GRDS), is a bariatric procedure that is composed of a restrictive and a mala-absorptive aspect. Restrictive portion of the surgery involves removing 75 to 80% (gastric sleeve) and the mala-absorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel.

The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver with digestive enzymes.

We recommend the Doudenal Switch as a great second time surgery form patients with a gastric sleeve with excess weight remain it is excellent for long-term success as well on the following observations were reported on the resolution of obesity related comorbidities following the duodenal switch: type 2 diabetes 99%, hyperlipidemia 99%, sleep apnea 92%, and hypertension 83%. Also the patients have a higher occurrence of smelly flatus and diarrhea, although both can usually be mitigated through diet, including avoiding simple carbohydrates.

This surgery takes about 1.30min to 2.5hrs on the operation room, 30 min to 1hr on the recovery room. After 4hrs the patient is able to walk, recovery is very fast one of the advantages of laparoscopic surgery. All medication like antibiotics, ant nausea, and analgesics are administrate intravenous, a Jackson Pratt drain is left for patient security witch is taking out on the third day of hospitalization. The surgery requires 3 days of hospital. all our patients get a private room with Tv, Air-conditioned, Restroom, and a sofa where a companion can stay overnight.