Duodenal Switch Surgery: How it Works

The duodenal switch (DS) combines malabsorptive elements to achieve weight loss. The DS procedure includes a partial gastrectomy, which reduces the stomach along the greater curvature, effectively restricting its capacity while maintaining its normal functionality. This means that part of the stomach is permanently removed.

Unlike the unmodified BPD and gastric bypass Roux-en-Y (RNY), which use a gastric “pouch” and bypass the pyloric valve, the DS procedure keeps the pyloric valve intact. This eliminates the possibility of dumping syndrome, marginal ulcers, stoma closures and blockages, all of which can occur after other gastric bypass procedures.

In addition, the duodenal switch procedure keeps a portion of the duodenum in the food stream. The preservation of the pylorus/duodenum pathway means that food is digested normally in the stomach before being excreted by the pylorus into the small intestine. As a result, the duodenal switch procedure enables “more normal absorption” of many nutrients (including protein, iron, and vitamin B12) than is seen with the gastric bypass Roux-en-Y procedure; however, it is more malabsorptive.

The Duodenal Switch Procedure

The malabsorptive component of duodenal switch surgery rearranges the small intestine to separate the flow of food from the flow of bile and pancreatic juices. This inhibits the absorption of calories and some nutrients. Further down the digestive tract, these divided intestinal paths are rejoined and food and digestive juices then begin to mix. Limited fat absorption occurs in the “common tract,” as food continues on toward the large intestine.

Some insurance plans will not cover duodenal switch surgeries, but as experienced duodenal switch surgeons, we will always work hard on your behalf to make the case for necessary coverage when the duodenal switch procedure is medically indicated.

Advantages of duodenal switch surgery include:

  • rapid weight loss (typical weight loss of 5+ pounds per week);
  • reduced capacity to eat large volumes of food;
  • no “dumping syndrome” as in the gastric bypass;
  • no band adjustments as with the gastric band;
  • fewer follow-up appointments than with the gastric band;
  • procedure is done laparoscopically;
  • proven success;
  • typical recovery period of 10 to 14 days; and
  • reduction or resolution of serious co-morbidities such as type 2 diabetes.


To make an appointment for duodenal switch surgery consultation with an experienced Houston duodenal switch surgeon, call The Davis Clinic at (713) 486-1755.