Dr. LeGrand performs the procedure laparoscopically, a minimally invasive approach, in about two to three hours. General anesthetic is used to put patients to sleep. Several small incisions will be made in your abdomen. Dr. LeGrand will insert narrow tubes in the incision that contain cameras and small surgical tools.

Duodenal switch is then performed in two steps. First, a gastric sleeve is performed. Eighty percent of the stomach is removed, and the remainder is converted into a slender tube. Second, Dr. LeGrand divides the small bowel from the stomach, the duodenum, to create the bypass. Consumed food will then go into the sleeve and then “switched” to the lower part of the small intestine bypassing the initial part of the small intestine. This portion of the surgery is similar to gastric bypass except a more significant length of small intestine is bypassed to create a single connection between the bottom of the sleeve and the small bowel.

Duodenal switch typically produces the greatest, and fastest, weight loss when compared to gastric bypass and gastric sleeve surgeries. Patients can expect to lose 70% to 100% of their excess body weight. Maintaining weight loss long term is also more likely with duodenal switch. Diabetes is resolved for up to 95% duodenal switch patients. Sixty-eight to seventy-five percent of patients experience a correction in their blood pressure. High cholesterol is lowered among 70% to 75% of duodenal switch patients.

One difference between duodenal switch and gastric bypass surgeries is the shape of the new, smaller stomach left behind when the largest portion of the stomach is removed. During gastric bypass, Dr. LeGrand makes a small pouch that bypasses the lower part of the stomach. With duodenal switch, the remaining stomach is converted into a slender tube instead of a pouch, more like gastric sleeve surgery.

The second difference between the two procedures is that Dr. LeGrand divides the small bowel from the stomach, the duodenum, to create the duodenal switch bypass. Consumed food will then go into the sleeve and then “switched” to the lower part of the small intestine bypassing the initial part of the small intestine. This portion of the surgery is similar to gastric bypass except a more significant length of small intestine is bypassed to create a single connection between the bottom of the sleeve and the small bowel.

Leading up to surgery, you’ll complete several evaluations and education preparing you for post-op success. You’ll practice new, healthy lifestyle skills early on because it takes time to develop new habits. Your results and success completely depend on your ability to permanently adopt healthy habits.

You may experience weight loss even before surgery because of your lifestyle changes. You should be encouraged by this weight loss and gain confidence in your long-term success. The duodenal switch surgery, as well as support from your medical and personal teams, will help you remain successful.

Two weeks before surgery, you’ll begin a very strict diet. Calories and carbohydrates will be restricted while your intake of lean proteins will be increased. These dietary changes will help shrink the liver and prepare your body for a smooth transition to a new lifestyle. An oversized liver could compromise your success and make the surgery more dangerous.

Two days before surgery, you will switch to a liquid diet that may include broth and protein shakes. You may also be able to drink decaffeinated coffee and tea and eat Jell-O. Avoid caffeine as it could impact your procedure. No two patients are alike, so Dr. LeGrand’s orders may vary.