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The duodenal switch (DS) procedure, also known as a gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. The restrictive portion of the surgery involves removing approximately 70% of the stomach (along the greater curvature) and most of the duodenum .
It is also used for the treatment of pancreatic or duodenal trauma, or chronic pancreatitis. [2] Due to the shared blood supply of organs in the proximal gastrointestinal system, surgical removal of the head of the pancreas also necessitates removal of the duodenum, proximal jejunum, gallbladder, and, occasionally, part of the stomach. [2]
The SADI-S is a single anastomosis bariatric surgery. It is different from the classic duodenal switch, the gastric bypass (RNY) or sleeve gastrectomy.It is a type of bariatric surgery carried out to lose weight and to mitigate various metabolic issues including type 2 diabetes, dislipidemia, metabolic syndrome, and polycystic ovary syndrome.
The operation usually performed is an antrectomy, the removal of the antral portion of the stomach. Other surgical approaches include: vagotomy, the severing of the vagus nerve, the Billroth I, a procedure which involves anastomosing the duodenum to the distal stomach, or a bilateral truncal vagotomy with gastrojejunostomy.
In addition, other side effects include dysphagia, which is when digestive juices in the duodenum flow upward to the esophagus, thus esophageal lining is irritated. Diarrhea is common, especially in patients who had vagotomy in addition to an antrectomy because the damage of nerves to the liver and gallbladder causes excess bile salt release.
For severe duodenal ulcers, it may be necessary to remove the lower portion of the stomach and the upper portion of the small intestine. If there is a sufficient portion of the upper duodenum remaining, a Billroth I procedure is performed, where the remaining portion of the stomach is reattached to the duodenum before the common bile duct.
The Malone antegrade continence enema (MACE), used to treat fecal incontinence, is like the Mitrofanoff procedure as it uses the Mitrofanoff principle and, thus, can be considered an analogous procedure. [8] As fecal and urinary incontinence frequently co-exist, a MACE is often created at the same time as a continent catheterizable urinary ...
This type of surgery appeared at the same time as end-to-side jejunoileal bypass. Some surgeons regarded this as a better option than end-to-side jejunoileal bypass because it prevented the reflux of ileal content to the blind loop. In order to achieve this, the end of the proximal duodenum is anastomosed to the distal ileum.
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