The Duodenal Switch Procedure: The Laparoscopic DS at The Advanced Obesity Surgery Center

The Laparoscopic Sleeve Gastrectomy with Duodenal Switch (DS)

The Laparoscopic Sleeve Gastrectomy with Duodenal Switch procedure, sometimes known as the Biliopancreatic Diversion with Duodenal Switch, combines elements of a restrictive operation with malabsorption of fat to give you a very powerful bariatric surgery procedure. You may have heard of the Duodenal Switch procedure referred to as the BPD/DS, the "Duodenal Switch", the "DS", or simply the "Switch".

Dr. Dennis Smith performs the Totally Laparoscopic Sleeve Gastrectomy with Duodenal Switch, with a Hand-Sewn Duodenal-Ileal Anastomosis. He was the third bariatric surgeon in the world to perform the totally laparoscopic Duodenal Switch procedure, and the first bariatric surgeon in the world to present the Hand-Sewn Duodenal-Ileal Anastomosis Technique of the Laparoscopic Duodenal Switch. There are few bariatric surgeons who perform the Totally Laparoscopic Sleeve Gastrectomy with Duodenal Switch procedure.

Dr. Smith has performed well over 300 Totally Laparoscopic Sleeve Gastrectomy with Duodenal Switch Procedures. We continue to do these procedures regularly, and our patients are from all over the US. We generally have very short wait times from your initial contact with our office to your surgery date, depending on what insurance and medical situations you have.

Advanced Obesity Surgery's safety record is among the best, and that's because Dr. Smith's focus is, and has always been on doing the safest surery possible rather than the most numbers of operations possible. We take the time to make sure each patient is taken care of as thoroughly and carefully as possible, pre-operatively, during surgery, and post-operatively. At this time, Dr. Smith is the only bariatric surgeon in a several state area around Georgia who regularly performs the Laparoscopic Duodenal Switch.

Dr. Smith also serves as faculty for courses in the Duodenal Switch for bariatric surgeons who are interested in adding the Duodenal Switch to their bariatric surgery armamentarium. He also has presented his Laparoscopic Duodenal Switch techniques and results at national and international meetings of bariatric surgeons.

Revisions to the Duodenal Switch

At this time, Dr. Smith will revise Lap-Band^® patients to the DS laparoscopically and in one stage, with removal of the Lap-Band^®.

Dr. Smith will also perform the Duodenal Switch bowel component on patients who have previously had the Sleeve Gastrectomy but have lost insufficient weight.

Revisions of the Sleeve Gastrectomy can also be performed using the StomaphyX^™ Procedure to tighten down the stomach pouch, if your pouch is now too large.

Please call for more informations about revisions involving the Duodenal Switch and StomaphyX^™.

Out Of State Patients

For those of you who are not from Georgia, we treat many patients from out-of-state, from all across the United States, and from other countries as well, and most come to Georgia for the Laparoscopic Duodenal Switch procedure.

Laparoscopic Duodenal Switch Video

WARNING: This video is graphic and contains actual surgery recorded on digital video! Do not watch unless you are fully prepared to see surgery taking place!

Press Center Play Button to begin Video. NOTE: This video has no narration at this time.

Lap Duodenal Switch Full WMV

Alternatively, you can watch other videos with Windows Media Player:

The videos presented for your viewing are of Dr. Smith performing the Laparoscopic Duodenal Switch. You'll need Windows Media Player to view them. They are streaming video, so they take a short time to buffer before the video begins playing. You can click on the image to the left to download the latest Windows Media Player.

Click here to watch a Streaming Video (9+ minutes) of Dr. Smith doing the Totally Laparoscopic Sleeve Gastrectomy with Duodenal Switch.

You may click here to watch a Video Clip of Dr. Smith doing the Duodeno-Ileal Anastomosis of the Laparoscopic Duodenal Switch, in which he does a hand-sewn, two layer sutured anastomosis laparoscopically.

You may click here to watch a Video Clip of Dr. Smith doing the Laparoscopic Sleeve Gastrectomy, in which the lateral 3/4 of the stomach is resected, leaving a narrow tubular stomach.

The Sleeve Gastrectomy is sometimes done in a staged manner, in order to reduce the risk that would be involved with doing the entire Sleeve Gastrectomy with Duodenal Switch Procedure at once. This is employed in situations where the Sleeve Gastrectomy portion of the operation might induce a substantial weight loss over a period of time such that the remainder of the Duodenal Switch Procedure could be performed at a much lower weight, and therefore a much lower risk.

There are also some situations where the Sleeve Gastrectomy might be useful as a stand-alone procedure. Click HERE for more information about the Sleeve Gastrectomy as a standalone procedure.

Our Poster on Laparoscopic Duodenal Switch, 2005 ASBS Meeting

Click to View .pdf of Poster Presented at the 2005 ASBS Meeting: Laparoscopic Biliopancreatic Diversion with Duodenal Switch in Patients with BMI > 60
Lap DS Poster

--Dennis C. Smith, Jr., MD, et al; The Advanced Obesity Surgery Center, WellStar Health System Bariatric Surgery Program, Marietta, Georgia, USA.
Conclusions: The completely Laparoscopic Biliopancreatic Diversion with Duodenal Switch is a safe, feasible and very effective operation for patients with BMI’s in the 60’s and above.
A single-stage Laparoscopic Duodenal Switch can be performed in patients with BMI’s > 60 with a very low morbidity and mortality.

The Laparoscopic Sleeve Gastrectomy with Duodenal Switch

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 three major operations, with few side effects.

The operation includes a "Partial Lateral Gastrectomy", or a "Sleeve Gastrectomy" that gives you significant restriction in how much you can eat. It also rearranges the small bowel, including the "Duodenal Switch", which contributes some malabsorption of the fat that you eat. The most important feature of the Duodenal Switch is that it diverts your food stream so that it is only in the last 75-100 cm, the "common channel", that your food can mix with your digestive stream, in order to be digested and absorbed. The result is a combination of a "restrictive" and a "malabsorptive" weight loss.

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.

Dr. Smith performs all of his Duodenal Switch operations totally laparoscopically.

Click Here for More Detailed Information on the Laparoscopic Duodenal Switch

You can get further information on the Laparoscopic Duodenal Switch by downloading the document: Bariatric Surgery: What Are My Options?

You can also download a Diet and Nutritional Guide for the Duodenal Switch Procedure (and for the other operations) as well as forms for beginning the process for you to become a patient at The Advanced Obesity Surgery Center on our Member Pages.

If you've had a LAP-BAND^®, and the weight loss has been inadequate, Dr. Smith will evaluate you for possible laparoscopic conversion to the Bilio-Pancreatic Diversion with Duodenal Switch procedure.

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For any questions, comments, or to begin the process, you can contact us:
Phone: 770-919-7050
Fax: 770-919-7051
Toll-Free: 1-866-535-0966
or email us at:
inquiries@advancedobesitysurgery.com

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The Advanced Obesity Surgery Center
A Certified Bariatric Surgery Center of Excellence
Marietta, Georgia, USA