Laparoscopic Duodenal Switch Surgery

Laparoscopic Duodenal Switch Surgery

A weight-loss surgery that reduces stomach size and bypasses part of the small intestine to limit calorie absorption.
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Key Information

The BPD/DS is a complex bariatric procedure that combines a reduction in stomach size (restrictive component) with rerouting the small intestine to absorb fewer calories (malabsorptive component).
The procedure involves laparoscopically removing a large portion of the stomach to create a cylinder-shaped pouch and rearranging the small intestine so digestive juices mix with food only in the last 15-20%.
It is associated with some of the best results; most patients lose 75% to 80% of their excess weight and maintain it. Weight loss is generally greater than with other bariatric procedures.
Key advantages include a greater degree of weight loss, long-term maintenance from malabsorption, the ability to eat more normally than with other procedures, and a lower risk of dumping compared to Gastric Bypass (RNY).

About Laparoscopic Duodenal Switch Surgery

The full name of this surgery is Biliopancreatic Diversion with Duodenal Switch (BPD with DS). This type of duodenal surgery changes the normal process of digestion by making the stomach smaller and allowing food to bypass part of the small intestine so that you absorb fewer calories.

You will feel full more quickly than when your stomach was its original size, which reduces the amount of food consumed and thus the calorie intake. Bypassing part of the intestine also means that you will absorb fewer calories. This leads to weight loss. Duodenal switch surgeries are very effective, where most patients lose 75% to 80% of their excess weight and maintain their new weight.

This procedure could be classified as a combination of a Gastric Bypass / Gastric Sleeve surgery with a twist. It is one of the most difficult and complex procedures to perform, but it’s also associated with some of the best results.

In a Biliopancreatic Diversion with Duodenal Switch (BPD with DS) a large portion of the stomach is laparoscopically removed to create a cylinder-shaped pouch connecting the esophagus to the top of the small intestine. 

An incision is made at the top of the small intestine, but the surgeon leaves part of the duodenum (the top part of the small intestine where most chemical digestion occurs) attached to the stomach. 

The surgeon then makes another incision on the small intestine several feet up from the end where it meets the large intestine/colon. The part that is still attached to the large intestine is then connected to the duodenum.

The loose part of the small intestine (the part that was not just attached to the stomach) is then attached to the small intestine, allowing the digestive juices it creates to mix with the food coming from the stomach in approximately the last 15 – 20% of the small intestine.

Since the stomach is shrunk and only a small portion of the intestine has a chance to digest food before the food enters the colon, this procedure is both restrictive and malabsorptive.

  • Mortality rates are similar to other Bariatric Procedures. 
  • Weight loss is greater after Duodenal Switch Surgery, compared to other Bariatric Procedures.
  • The main advantage of Duodenal Switch Surgery compared to Gastric Bypass (RNY) is that dumping does not occur.
  • The Duodenal Switch is effective both from the restrictive component and the malabsorptive component. Most of the early weight loss comes from the restriction and the long term weight loss maintenance (lack of weight regain) is from the malabsorption.
  • People who have had the Duodenal Switch eat much more normally than those who have had other weight loss operations (Laparoscopic Adjustable Gastric Band or Roux-en-Y Gastric Bypass).  In fact it is entirely normal for these people to be able to eat a small steak, chicken, salad, or pasta without difficulty where it is a rare person that can do this with the other weight loss operations.

Before traveling to Cyprus, as part of your Duodenal Switch Surgery preparation you will complete a detailed bariatric specific questionnaire, which will allow our doctors to determine your eligibility for Duodenal Switch Surgery. If you are not ready to make lifestyle changes, you will not be considered eligible for the procedure. 

To help you adjust to your new lifestyle, we advise you to empty your home of all edible “temptations”, creating a suitable environment for your return, post operatively.

Ten days prior to your arrival in Cyprus, you will receive all the necessary pre operative instructions, to prepare yourself both physically and mentally for your chosen procedure.

After hospital admission, you will receive psychological advice. This will help you adhere to a healthier lifestyle. Without changing your lifestyle, the surgery will not be a success. You will also receive nutritional counseling before (and after) your surgery, by our specialists.

Most people typically stay in the hospital for 4 days or less after duodenal switch surgery, followed by a stay in a nearby hotel for 4-7 days. Your surgeon will approve your release once you can do the following:

  • Move without too much discomfort
  • Eat liquid and/or pureed food without vomiting
  • No longer require pain medication given by injection

You will remain on liquid or pureed food for several weeks after the surgery. Even after that time, you will feel full very quickly, sometimes only being able to take a few bites of solid food. This is because the new stomach pouch initially only holds a tablespoonful of food. The pouch eventually expands. However, it will hold no more than about one cup of thoroughly chewed food.

Once your diet begins to consist of more solid food, remember to chew each bite very slowly and thoroughly. You will be instructed on eating small meals frequently throughout the day, rather than large meals that your stomach cannot accommodate.

Exercise and the support of others are extremely important to help you lose weight and maintain that loss following Duodenal Switch Surgery. You can generally resume exercise 6 weeks after the duodenal switch operation. Even sooner than that, you will be able to take short walks at a comfortable pace, with the approval and guidance of your doctor. Exercise improves your metabolism, while both exercise and attending a group support can boost your self-esteem and help you stay motivated.

Following your recovery diet you will slowly begin to introduce new foods in increasing quantities until about 6 months after surgery when your new bariatric diet will be in full swing. 

Assuming you follow the diet and exercise guidelines of our surgical team, all indications are that weight loss and health improvement following Duodenal Switch surgery may be permanent. The Duodenal Switch has an initial 12 to 18 month “honeymoon period” following surgery. During this time, patients usually experience a rapid and significant amount of weight loss. The “extended honeymoon period” with the DS can last three to five years – during which time patients will typically not experience weight regain. 

All weight loss surgery however, requires a complete change in diet for your procedure to continue to be effective and Duodenal Switch is no different. Some patients are likely to experience weight regain as a result of your stomach stretching over time if the diet and exercise guidelines are not followed.

After surgery, you will need a new nutrition plan. Our surgeon and/or dietitian can help you learn about and get used to the changes in lifestyle and eating habits you need to make. It is very important to follow the eating and drinking instructions beginning immediately after the operation. 

In the first few weeks after your surgery, you will be on a liquid diet since only thin liquids will be tolerated by your stomach at that time. As you heal, you will gradually progress to pureed foods (three to four weeks post-op) and then soft foods (five weeks post-op). Finally, you will be able to eat solid foods.

When you are at the stage to eat solid foods without problems, you will need to pay close attention to your diet. It is recommended that you eat only three small meals a day and make sure that these meals contain adequate nutrients. Foods that have a concentrated supply of calories with little nutritional value, such as milkshakes, syrups, jam, and pastries, should be avoided as much as possible.As mentioned above, due to the extent of malabsorption after surgery you will need to take 10 to 15 pills per day for the rest of your life. If you stop taking any prescribed vitamins, you will be twice as likely to develop vitamin deficiency. To the average person, not getting enough vitamins does not sound like a big deal. But when you change the architecture of your digestive system to the extent of the Duodenal Switch, it can become a life-threatening problem. Routine blood tests and follow ups with ensure your body is getting enough supplements.

Exercise is very important and incorporating regular physical activity into your daily routine is as important as following your nutrition plan. 

Often Weight Loss Surgery patients have been inactive due to decreased activity tolerance, psychological constraints and in some cases, physical disabilities. After Duodenal Switch aerobic activities, particularly walking and gentle swimming are generally best tolerated. Your surgeon will advise you on which activity is right for you.

The weight loss results of Duodenal Switch surgery are generally very good. In the first year following surgery, percent of excess weight lost following Duodenal Switch surgery is between 48% and 65%.  Over the long-term, patients lose as much as 75% of their excess weight. Often, the greatest rate of weight loss occurs in the very beginning (that is, just following the surgery when you are still on a liquid diet).

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Doctors performing Laparoscopic Duodenal Switch Surgery

All procedures at GMS Cyprus are performed by internationally recognized surgeons from Israel, the EU, and the US. Each selected for their exceptional qualifications, surgical expertise, and commitment to patient care.

Our doctors are leaders in their fields, with extensive experience in advanced techniques and consistently high success rates. They work closely with our medical board and patient support team to ensure each treatment is safe, effective, and tailored to the individual.

The GMS Cyprus Promise

We are committed to providing every patient with access to world-class surgeons, personalized care, and unwavering support throughout their medical journey.

We carefully select our surgeons based on international standards, clinical excellence, and patient outcomes. We believe that medical travel should be stress-free, transparent, and guided by people who genuinely care. Our promise is to treat you with dignity, protect your privacy, and give you peace of mind every step of the way.

How it works

Step 1
Submit a consultation request
Fill out a short form and let us know your medical concern. A coordinator will contact you within 48 hours.
Step 2
Share Your Medical History
Send your relevant documents (scans, reports, etc.). We’ll help you prepare them and handle translation if needed.
Step 3
Receive your medical proposal
Receive a detailed proposal, including surgeon profile, recommended treatment, estimated costs, and recovery plan.
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Testimonials

Ilanit Boker

Ilanit Boker

I happily recommend the services of the GMS team. I needed a unique procedure which is not performed in Israel and I turned to them. 

Over a telephone conversation with GMS representative Roy, I felt caring attention and confidence that he would help in everything. He accompanied us throughout the entire process, before the flight and even after. 

In addition to Roy, we would like to sincerely thank Oriya, our allocated Israeli speaking patient coordinator of the company in Cyprus. 

Even before our departure, Oriya was in touch with us helping with any issues and made sure that we arrived fully prepared – taking into account the smallest details; even to the point of finding out our food preferences, and despite the late hour of our arrival at the hotel, she ensured an exquisite meal was waiting for us in the room. Oriya greeted us upon arrival and truly made us feel like we were her personal guests. She accompanied us throughout the entire day of the operation – attentively, with endless care and continued patience.

I felt like I had a good friend with me in the hospital. This kind of treatment doesn’t happen very often… At the end of the day we parted, hugging each other, and Oriya gave recommendations on where to go and what to do in the time remaining before returning home.

I just don’t have enough words to thank GMS and Oriya for everything. I can only recommend with a reassurance that those who need it should use their services.

Almog Brand

Almog Brand

When I was looking for information about palm surgery, I found many recommendations about Dr. Amir Oron. After a consultation with Dr. Amir, I was surprised to learn that my health insurance does not guarantee that he will be the surgeon to perform the procedure.

That is when I contacted GMS, who explained how I could have the surgery performed by the physician of my choice – which gave me peace of mind. It is very important for me to share my experience, as the service I received through GMS exceeded any similar experience in Israel: From the beginning I was assigned a GMS representative from Israel, who explained in detail what my experience would be and answered all my questions about the operation and the treatment process. (Thanks, Roy!)

All I had to do was fill out the application form. GMS representatives took care of everything themselves!

They contacted the insurance company on my behalf and even had them check the status of the application until the financial commitment for the surgery was received. We agreed with on the surgical date, booked the flights at a convenient time for me, and also dealt with the hotel reservation. The GMS staff even reviewed the menu and took any dietary restrictions into consideration on my behalf.

We were picked up from the airport in Larnaca, Cyprus where we met the wonderful Oria, who accompanied us throughout the entire visit and took care of every detail; from registration to preparation for the operation.

This is essentially a VIP service that made the entire experience relaxed and stress-free.
The assigned coordinators continued caring after my return to Israel. They were interested in my recuperation post-operatively and also ensured all financial matters were dealt with; all this, by the way, without any commissions or payouts on my part, but directly with my insurance.
In a word – an amazing experience!
In short – I recommend it!

Thank to GMS, thank you Roy, thank you Uriah and thank you Dr. Oron.

Nirit Shortz-Raphael

Nirit Shortz-Raphael

I do not even know where to start!!
Overall, the service exceeded all my expectations!

Roy – thank you for your patience, quick responses (minutes!), availability, caring and clear explanations! You are inimitable! Oriya – you are amazing! Thank you for every smile, hug, help, guidance, explanation… really! You are simply amazing!

Every time I was asked by friends and family about the surgery, I immediately started talking about your amazing service! I felt warmth and love, and everyone who was with me felt the same!
We never stop talking about you, and really, only good things!

You have entered our hearts!
Thank you very much for everything! I hope to see you in the future, under different circumstances.

Nadav Ben-Ezer

Nadav Ben-Ezer

When one thinks of “Medical Operation” overseas, the last thing that comes to mind is a “Great Experience”, but this is exactly what I have experienced, going through a prostate removal procedure via GMS Cyprus. With their professional and compassionate approach, the GMS Cyprus team provides to the confused and worried patient a complete transparent VIP envelop, which takes care of all the logistics involved in “Medical Tourism” for the patient and their escort, as well as assembling a world class international medical team and medical facilities suitable to treat the medical diagnosis at hand.

From the first time the medical situation was diagnosed, and the first contact was made, the GMS team was there to remove the hassle and understand my concerns and worries about the medical issue and being far from home, and they handled every detail of the logistics of travel, insurance company requirements and medical preparations. From first arrival at the luxurious hotel, assigned to the first night and for my personal escort, the GMS management, Udi and Clair, has treated me as family away from home and personally came to greet me and attend firsthand to all my needs and requests. To top it all, they assigned their own personal escort, the wonderful Aia, which was available 24/7 and door to door to handle any need and detail and helped interface with the local hospital team.

I want also to recommend the choice of the hospital at Limassol, which is modern and clean, and of course GMS team have in advance reserved a private and spacious room and nominated a local doctor, which was familiar with my case and participated in the treatment and which came often to check my condition and parameters.

To summarize, I would not go so far as to wish such treatment to anybody, but if you must go through the medical procedure, the VIP treatment provided by GMS is a legitimate alternative, combining easy logistics, professional medical treatment by your own doctor, modern hospital, relaxed overseas experience and personal compassionate escorting to ease and sweeten the experience.

Dorit

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Have questions? Contact our team for a free consultation and find out how GMS Cyprus connects you with top international surgeons and personalized care.

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