Laparoscopic biliopancreatic diversion with sleeve gastrectomy (Duodenal Switch)

Q: Will I be sick a lot after the operation?

A: The duodenal switch limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well or that you are not following the diet rules properly. Vomiting should be avoided during the early stages of recovery while your new stomach heals.

Q: How long will it take to recover after surgery?

A: As weight loss surgery is performed laparoscopically, patients typically spend 5-6 days in hospital. It takes most patients about 4 weeks to return to work and six weeks to resume exercising.

Q: How much weight will I lose?

A: Weight-loss results vary from patient to patient, and the amount of weight you may lose depends on several things. However, with the restriction from the sleeve and malabsoprtion of the intestines the average excess weight loss achieved is 80-90%. Twelve to eighteen months after the operation, weekly weight loss is usually less. Your main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity.

Q: Does weight loss surgery require frequent office visits after surgery?

A: It is important to be reviewed in the clinic on a regular basis for life. You should have regular blood tests to check your vitamin and mineral levels, and be reviewed by your surgeon or nurse. In the long term you should have a medical check up twice a year, and under a DEXA scan to check your bone density every two years.

Q: Does the duodenal switch restrict any physical activity?

A: The gastric bypass does not affect or hamper physical activity including aerobics, stretching and strenuous exercise.

Q: Will I need plastic surgery for the surplus skin when I have lost a lot of weight?

A: With massive weight loss, this can be likely. As a rule, plastic surgery will not be considered for at least a year or two after the operation. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery. However, the more you exercise during the first year following surgery the more fat you burn and muscle you tone.

Q: Will I feel hungry or deprived after the duodenal switch?

A: This is rare. A feeling of fullness is common with small portions following a duodenal switch. The challange with this type of surgery is to eat sufficient protein every day (100g a day is recommended).

Q: What will happen if I become ill or need an operation?

A: The duodenal switch, although restricting your food intake and absorption, is not affected by illness. However, prior to undergoing further abdominal surgery it is wise to speak with your surgeon.

Q: What about pregnancy?

A: Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. It is possible to have a safe pregnancy with a duodenal switch, but it is essential to undergo regular blood tests during pregnancy to ensure you do not become deficient in essential vitamins and minerals.

Q: Will I need to take vitamin supplements?

A: Absoulely. It is essential that you take daily supplementation in the long term. These include a multivitamin as well as extra iron, zinc and calcium – for life.

Q: What about other medication?

A: You should be able to take prescribed medication. You may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck and make you sick. You should always ask the doctor who prescribes the drugs about this.

Q: What if I go out to eat?

A: Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

Q: What about alcohol?

A: Alcohol has a high number of calories. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.

Q: Can I eat anything in moderation?

A: After your stomach has healed, you may eat most foods that don't cause you discomfort. However, because you can only eat a little it is important to include foods full of important vitamins and nutrients. It is essential to consume 100g of protein in your diet daily to avoid protein malnutrition. If you eat foods that contain lots of sugar and fat or drink liquids full of "empty" calories, such as milkshakes, the effect of your surgery can be reduced, and will increase the frequency of bowel movements.

Q: Will I suffer from diarrhoea?

A: This is a recognised side effect of having extreme malabsorption. You can experience bowel movement up to 5-6 times a day.