Diagnosis for Duodenal switch surgery
Duodenal Switch surgery is a major surgery and should be considered at last resort when other weight loss alternatives have failed. Surgery advised in people with:
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Duodenal switch Procedure
Patient will be evaluated by the surgical team, clinical dietitian and a psychologist.
Complete medical history will be taken .
Series of preoperative blood tests and x-rays are performed to check fitness for surgery
If you are a smoker, you will be advised to stop smoking
The surgeon will explain you regarding the benefits , potential risks , after care after the surgery .
Procedure may take 4-6 hrs .
Procedure has two components the restrictive component and malabsorptive component .
First, a smaller, tubular stomach pouch is created by removing a portion of the stomach.
Then, a large portion of the small intestine is bypassed.
The last portion small intestine is brought up and connected to the outlet of the newly created stomach. Roughly three-fourths of the small intestine is bypassed by the food stream.
The bypassed small intestine is reconnected to the last portion of the small intestine .
Occasionally the removal of gallbladder is performed to prevent gallstone that often accompanies rapid weight loss .
Duodenal Switch is sometimes performed in two stages when the surgeon determines it is too risky for the patient to undergo the whole procedure at once. The surgeon will perform stage one, restrictive component, then when the patient has lost some weight , then stage two, intestine switch, is performed.
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Kept in recovery room for monitoring of vitals
There will be tubes and drains placed - Occasionally, a tube may be placed through the nose into the stomach at the end of surgery.
Medications for pain relieving will be administered after surgery.
Patient is made active soon, it is a important to prevent pneumonia, blood clots, and constipation.
Compression stockings are advised to help blood circulate, thereby preventing blood clots.
A Spirometer is used to every hour to help prevent breathing problems.
Patient is kept nil by mouth (NBM) on day 1 after surgery.
If no signs of leak then on second day clear liquids and water administered.
First week -Full liquids including 2 high protein drinks daily.
Second and third week -Pureed soft food .
Followed by regular diet after consultation with dietician and surgeon.
Patients should schedule postoperative visit 2-3 weeks after discharge. Follow-up visits are scheduled every 6 months throughout lifetime.
Complications of Duodenal switch
All surgical procedures involve a degree of risk , there may be complications of duodenal switch like:
Stomach leak- Leakage from staple line along the line of resection of the stomach
Intestinal leak-leakage at site of intestinal anastomosis
Malnutrition -Nutritional deficiency is one of the major complications of duodenal switch due to reduction in the absorptive surface.
Deep vein thrombosis
Gastroesophageal reflux disease
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Factors Affecting Cost of Duodenal switch Surgery
The cost to the patient depends on a variety of factors like
The hospital, the patient chooses.
The room charges , OT, procedure charges
Fee for the surgeon and team of doctors.
Cost of medicines
Standard test and diagnostic procedures.
Cost of the follow –up care required after the procedure.