2014-10-07T09:33:45+00:00
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Duodenal Switch Surgery Abroad

Duodenal Switch Package Cost: from $7,000
{Duodenal Switch quote cover all the medical & logistics costs at the destination}

India [Harvard Medical Affiliated & USA JCI Accredited Hospitals]
Mexico [World Class Hospitals]
Belgium [Popular European Medical Tourism Hospitals]

The Duodenal Switch (DS) also known as Biliopancreatic Diversion (BPD) with Duodenal Switch is a form of weight loss surgery that is not as frequently employed as the other forms like gastric lap bandsleeve gastrectomy or gastric bypass surgery. Though there are both pros and cons to the Duodenal Switch Surgery as with any other surgery, it is generally agreed now that DS results in quicker and greater weight loss than the other two procedures (This surgery is also recommended for some patients with Type 2 Diabetes.)

In this page, we will first discuss about the procedure involved in Duodenal Switch, its benefits and drawbacks, how to prepare for the surgery, what to do after the surgery, how it compares with lap band and gastric bypass, and lastly, the medical tourism centers in India & Mexico where you can go in for low cost duodenal switch surgery.

How is the Duodenal Switch Surgery performed?

The surgical procedure of a duodenal switch includes cutting away a part of the stomach, leaving behind a banana-shaped stomach. The rest of the stomach is discarded. This partial gastrectomy divides the stomach along the greater curvature, and the part that is removed is nothing more than a mass of acid-producing tissue. This is the restrictive aspect of the procedure. One of the important things that happen because of this partial gastrectomy is that the hunger-inducing hormone ghrelin is produced in much lesser quantity.

The malabsorptive aspect of the surgery involves rerouting a lengthy portion of the small intestine, creating two separate pathways and one common pathway. The shorter of the two pathways, the digestive loop, takes food from the stomach to the large intestine. The much longer pathway, the bilio-pancreatic loop, carries bile from the liver to the common path. Here, the food mixes with the bile from the bilio-pancreatic loop before emptying into the large intestine. This arrangement is done to reduce the amount of time the body has to ansorb calories from the food in the small intestine and to selectively limit the absorption of fat. Sugars, protein and nutrients are absorbed to a limited degree in the food tract. Fat absorption occurs only in the common tract. Therefore shorter the common tract, less fat absorption will occur.

The Duodenal Switch surgery in India & Mexico is usually an open surgery, but it can also be done laparoscopically, that is in a minimal invasive way. But not all bariatric surgeons have the expertise to perform a laparoscopic duodenal switch. And neither are all patients suited for this method of surgery.

Biliopancreatic Diversion

History of Duodenal Switch

The Duodenal Switch procedure (without the accompanying gastric bypass as used in weight-loss surgery) was originally devised by Dr Tom R. DeMeester to treat bile gastritis. But it was Dr. Douglas Hess of Bowling Green, Ohio, who, in 1988, became the first surgeon to combine the DS with the Biliopancreatic Diversion (BPD) as a form of obesity surgery. American Society for Bariatric Surgery has some intresting information on biliopancreatic diversion duodenal switch surgery.

Who Qualifies for Duodenal Switch Surgery

Doctors usually accept only super-morbidly obese patients or patients for whom other weight loss surgeries have not worked for the Duodenal Switch surgery(Super-morbidly obese means a BMI of 50 or more). Other conditions that may be considered are:

  • You have been obese for at least 5 years.
  • You do not have a history of alcohol abuse.
  • You do not have untreated depression or another major psychiatric disorder.
  • You are between 18 and 65 years of age.

Also the doctors from each country India, Belgium or Mexico may have their own selection criterias.

Advantages of Duodenal Switch Surgery

  • Quicker weight loss and fewer chances of gaining weight back. The Duodenal Switch combines moderate intake with substantial calorie malabsorption. This results in a very high percentage of excess weight loss for obese individuals.
  • Significant reduction in excess body fat.
  • No dumping syndrome, that is, patients do not feel nauseous.
  • Patients can eat a normal balanced meal.
  • No risks of staple line problems, clogging of the anastomosis, or ulcers at the stoma, because there are no pouches or stomas. The natural stomach is still there, only smaller, and is connected to the duodenum in the same as it was before the surgery.

Disadvantages of Duodenal Switch Surgery

  • Duodenal Switch patients need to take vitamin supplements throughout their life, because of the malabsorptive aspect of the surgery. Otherwise, they can fall seriously ill. Vitamin A deficiency can cause night blindness and Vitamin D deficiency can cause osteoporosis. Go for Duodenal Switch only if you are sure you can keep up with the vitamin supplements and higher protein supplementation requirements.
  • Life-long follow-ups are necessary.
  • Initially, there will be loose or foul-smelling motions and excessive gas formation. However, with a few patients, this could become a lifelong condition to be put up with.

How to prepare for the Duodenal Switch Surgery

As with any other surgery, you must completely understand the procedure of the Duodenal Switch and have realistic expectations from it. See the Duodenal Switch as a very effective tool to aid your weight loss, but remember that unless you follow your doctor’s instructions strictly throughout your life, you could be in serious trouble.

As for preparing for the surgery, the doctor will advise you on specific diets to be followed weeks or days before the surgery. If you smoke, it’s a good idea to quit well before the surgery. On the day before the surgery, eat at the precise times suggested by your doctor. Let your doctor know well in advance the various medications you are taking and ask him/her what can be continued and what has to be stopped.

Post-operative care for BPD/DS:

Diet after Duodenal Switch (please note below are general guidelines, your bariatric surgeon will be the best person to advise on the post duodenal switch surgery care :

  • For the first week after discharge, consume one ounce of pureed foodOR one to two ounces of liquid not more than once every 20 minutes while you are awake.
  • For the next 2 weeks, all food must be pureed or soft.
  • Consume 80-120 grams of protein everyday.
  • Make 1-2 choices from the milk group and 8-15 choices from the protein group per day.
  • Consume at least one protein supplement daily.
  • Eat slowly. Stop eating when you are comfortably satisfied.
  • Do not eat foods that are high in fat.
  • No fluids for 30 minutes after a meal.
  • Drink as much fluid as possible throughout the day.
  • Drink slowly and do not use a straw.
  • Do not drink alcoholic or carbonated beverages for a month after surgery.

Some Precautions to be taken after BPD/DS:

  • Do not drive until you have no pain and require no pain medication.
  • Avoid strenuous activity for at least a month.
  • Walk as much as you comfortably can. Do not strain yourself.
  • DO NOT get pregnant for up to 18 months after the surgery.

Duodenal Switch versus Lap Band and Gastric Bypass Surgery

Recent research has shown that for super-morbidly obese patients, duodenal switch could be better than gastric bypass surgery. This study involved 350 super-obese patients who underwent weight-loss surgery at the University of Chicago Hospitals between 2002 to 2005. One hundred ninety-eight patients underwent duodenal switch and 152 had a gastric bypass. When they were weighed one year after surgery, DS patients had lost an average of 149 pounds compared to 121 pounds for gastric bypass patients. After three years, DS patients had lost 173 pounds, but average weight loss for gastric bypass patients had decreased to 118 pounds.

However, there isn’t one ideal bariatric surgery which suits everyone. The duodenal switch surgery is far more complicated than either the gastric bypass or lap band surgeries. Hence, it is not performed as widely as the other two bariatric surgeries.

Below is a comparison of duodenal switch with gastric bypass and lap band surgeries:

  1. Biliopancreatic Diversion with Duodenal Switch does not cause dumping syndrome, whereas a gastric bypass does.
  2. Gastric bypass and lap band surgeries do not involve life-long follow-up program or taking vitamin supplements throughout the patient’s life. However, this is mandatory for Duodenal Switch patients.
  3. Procedural differences: In gastric bypass or RNY, pouches are made to divide the stomach. The intestines are then rerouted by connecting them directly to the new stomach pouch, bypassing the duodenum. The pyloric valve (which regulates the emptying of stomach contents into the duodenum is bypassed and therefore doesn’t function after the surgery. However, in the DS procedure, the surgeon creates a smaller stomach by removing about 75% of the stomach (partial gastrectomy). The top part of the gastric bypass is connected below the duodenum which keeps the upper part of the digestive process the same as before surgery (except that stomach is smaller). Your pyloric valve continues to regulate the emptying of the stomach contents into the duodenum and all the hormones and secretions that occur in the duodenum continue after surgery.

Duodenal Switch Surgery in India

The cost of a Duodenal Switch in the US is upwards of $45,000, which is a steep amount for most people. Hence, there is a popularity of having a duodenal switch in India. The cost of Duodenal Switch in India is $12,000 – $17,000. Even after adding other costs like accommodation, the price still remains attractive.

But it’s not just the cost that is attractive, what lures more and more medical tourists to India is its high standards of medical care. Tourist hospitals in Indiacompare with the best in the US or UK. They are either JCI/JCAHO-accredited or have an international certification like ISO. Bariatric surgeons in India are well qualified and often more experienced than their US or UK counterparts, because of the sheer number of patients that they handle.

Also, medical tourism in India is a multi-million dollar industry. Hence, you will be treated like a VVIP in India – something that you will surely not get in the US.

Duodenal Switch Surgery in Mexico

The cost of duodenal switch in Mexico is $8,800 – $18,800. The reason why such low costs are possible in Mexico is because that generally everything in Mexico costs lesser than what it would cost in the US. Land is less expensive, so is labor; there are also lower taxes, lower administrative costs, lower insurance rates and so on.

Mexico has all the advantages that India offers and more: Mexico is the nearest quality medical tourism destination for the US patients. You can fly or just drive down to Mexico. For a large part of South-Western US, Mexico is just a pleasant ride away. Duodenal switch surgeons in Mexico are quick to adopt the latest technologies, unlike their US counterparts who have to wait a long time for FDA clearance.

The medical staff, at tourist hospitals in Mexico speaks English fluently, as a large number of their clientele comes from the US. Furthermore, Mexican hospitals are spotlessly clean, and have airy and large patient rooms. They also have state-of-the-art technology and gadgets that are in use in the US.

Whichever country you choose for the duodenal switch surgery, be sure to choose the right hospital, and most importantly, a bariatric surgeon who has enough experience in doing Duodenal Switch Surgery, since the procedure requires a lot of expertise.

Weight Loss Surgery Cost Resources

Medical Tourism Corporation facilitates low cost duodenal switch surgery abroad at many international locations including Mexico, Belgum & India. Fill out the free estimate request form for a free quote & more information.

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