Programs : Advanced MI & Robotic Surgery

Biliopancreatic diversion with duodenal switch (BPD/DS)
The Biliopancreatic diversion with duodenal switch is similar to the Roux-en-Y gastric bypass in that the size of the stomach is decreased, causing restriction when food is consumed. Unlike the RYGB, the unused portion of the stomach is removed from the body with BPD/DS. The pyloric valve, which is responsible for regulating the release of food from the stomach into the small intestine is kept intact with this procedure. Near the pyloric valve, the small intestine (duodenum) is divided and the portion that is attached to the stomach is connected to small intestine that is closer to the large intestine. The remaining
segment of the duodenum that is connected to the pancreas and gallbladder is attached to the limb closer to the large intestine. The area where the contents of these two limbs mix is called the common channel, which then dumps into the large intestine. In addition to promoting weight loss via restriction, BPD/DS promotes weight loss through malabsorption. By separating the flow of food from the bile and pancreatic juices, food moves through most of the intestinal tract without being absorbed.

Advantages
• Increased amount of food intake compared to the gastric bypass and lap band
• Less food intolerance
• Possibly greater long-term weight loss

Disadvantages
• Postoperative healing: Surgery is more extensive, with re-routing of digestive organs. There is more pain and it takes longer to heal from this procedure than from the LAP BAND®.
• Hospitalization: Usually three days in the hospital
• Permanent: This procedure is not reversible