TYPES OF SURGERY THAT WE DO
DUODENAL SWITCH
This type of surgery is called MIXED, since it is made up of two fundamental elements:
1) Diminution of the gastric capacity and
2) Bad absorption of fats
It consists of making a partial resection of the stomach, in vertical direction, considering the filling mechanism as well as the evacuating one, which allows that in spite of leaving a stomach of minor and smaller capacity, the stomach operation practically remains the same.
This represents a unique advantage and, that no other type of surgery offers, since people can eat in a normal way, but in smaller amount and also there is another advantage, although the stomach capacity is reduced, is bigger than in the most of other surgical procedures.
The second mechanism of the surgery consists on turning aside the food route, causing it, while passing through the stomach to continue their way in direct form to the small intestine.
The small intestine is previously divided in the ileum segment, to allow food travel by a 50% approximately, of what it would cross in a normal way.
Therefore, the foods only have half of the intestinal surface to be totality benefited, but most important is that fats are minimally absorbed with the change of length.
Additionally, gall bladder and the appendix ceci could be extracted, with a previous information and consent of the patient. This surgery has been done for more than 20 years, having some modifications that have improved its results.
Now it is available by laparoscopic surgery or by the conventional form with an incision above the umbilical scar.
Advantages
a) It is the surgery that obtains better weight loss results near the 85-90% of loss of the excess of weight within 12-18 months since the surgery.
b) It allows the patients to eat practically in a normal way, with a minim or null probability of feeling nauseous, vomits or a food stuck sensation technically called dysphagia
c) This surgery diminishes the diseases associated with the obesity, because of the obtained weight loss, that even allows cutting off the medication need.
d) If this surgery is taken by laparoscopic procedure, the advantages of this mean itself are added, with less pain and faster recovery.
e) It has been proved that this procedure maintains the lost of weight by more than 15 years, even if patients eat greater caloric content foods, this surgery assures its results by the second mechanism, the one of bad intestinal absorption which would be in charge of not gaining weight .
This is, without a doubt, the most important and fundamental goal of obesity surgery.
f) It improves more than the 85% of the surgery-performed patients.
Disadvantages:
a) Because stomach resections and intestinal connections are done, the probability of intestinal content leaks is possible in the first days since the operation. This is called fistula and can happen in approximately in 1 to 2% of the cases.
b) Also longer recover time in the hospital is required, around four days, because it is necessary to pay special attention to fistula problems and other complications.
c) It requires taking vitamins and calcium supplements permanently after the surgery. In case of not doing it, long term complications by the lack of these nutrients can happen. In addition, it can require of periodic supplements of B12 vitamin and iron.
d) The probability of diarrhea after the surgery is from 1 to 3%, and nevertheless, it can be corrected with diet and medicines adjustments. Generally, if this problem appears, it would be within the first 6 months. If diarrhea gets so severe it could require another surgery to correct the lengths of the intestine, which makes this surgery partially reversible.
e) Excretions and gases can have an intensely fetid scent, and can be controlled with diet adjustments.
f) It is recommended to visit the doctor three to four times during the first year, with controlled examinations. Then once a year, it will be sufficient to watch the possible lack of vitamins or minerals.
