The Laparoscopic Sleeve Gastrectomy with Duodenal Switch gives you the best weight loss (an average of around 80-85% of excess body weight) of the four major types of surgery, with few side effects. It also provides the most durable weight loss, with the best protection against weight regain over the years. The operation includes a "Partial Lateral Gastrectomy", also known as a "Sleeve Gastrectomy" that gives you significant restriction in how much you can eat. The Sleeve Gastrectomy portion of the operation also helps alter the hormonal impulses that come from the stomach, resulting in less feelings of hunger. The complete Duodenal Switch operation also involves the small bowel bypass component, sometimes referred to as the "Duodenal Switch" portion of the operation, which adds malabsorption. This rearranges the small bowel, bypassing a significant portion of the small bowel, so that there is some malabsorption of the fat that you eat. The small bowel bypass causes a diversion of your food stream, keeping it from mixing with the digestive juices until much later in the small bowel. It is only in the last 100 cm or so, the "common channel", that your food can mix with your digestive juices stream, in order to be digested and absorbed. The overall result is a powerful combination of a "restrictive" and a "malabsorptive" weight loss, that is the best and most durable weight loss of any of the four major bariatric procedures. The Laparoscopic Duodenal Switch is especially good for you if you have a great deal of weight to lose, if you have severe insulin dependent diabetes, or if you have hypertriglyceridemia. As your stomach stretches out with time, you would usually be able to eat relatively more afterward, however the stomach is limited in its ability to stretch. This operation does require adherence to a postoperative diet for best results, as does the Laparoscopic Roux-en-Y Gastric Bypass. Drs. Smith performs all of his Duodenal Switch operations totally laparoscopically.
