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                   Laparoscopic Duodenal Switch

 

LapDS

The laparoscopic duodenal switch is a procedure this office offers to super-obese patients or patients with BMI over 70 or weight over 450 p. It is considered by many surgeons an aggressive bariatric procedure when compared to the laparoscopic gastric bypass with a Roux Y Limb or the LapBand™.

 

Many surgical groups are performing this procedure "open", others via a laparoscopic-assisted technique. This office prefers a pure laparoscopic approach which we believe decreases the recovery time and the complication rate. Nonetheless this procedure remains technically very difficult. In addition, it is associated with a higher rate of immediate post-operative complications when compared to the laparoscopic gastric bypass with Roux Y Limb. 

We classify this procedure as a bariatric, malabsorptive procedure. It combines a laparoscopic partial gastrectomy or gastric reduction component [removing 70% of the stomach] and a complicated, extensive bypass of the small intestine. This procedure is sometime "staged", meaning the patient will initially undergo the laparoscopic gastrectomy or gastric reduction to be followed and completed by the duodenal switch with bypass via laparoscopy a few months later.

 

This procedure will generate a pronounced and sustained weight loss but will also generate significant long term side effects and complications. Although some authors are reporting good, early results in the super obese patient population, we urge all prospective candidates for this particular procedure to study the medical literature and the long term side effects of this procedure.

Although we believe this procedure has a "defined place" in the surgical management of the super-obese patient, others surgical laparoscopic alternatives are beginning to

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