The single-anastomosis duodenal switch, also called stomach intestinal pylorus sparing surgery (SIPS), or the single loop DS, is very similar to the standard duodenal switch operation, except that the small intestine is only transected at one point instead of two. With this operation, the majority of the most stretchable portion of the stomach is permanently removed (as in a sleeve gastrectomy) but basic stomach function remains the same. In addition, roughly half of the upper small intestine is bypassed, resulting in a moderate decrease in calorie absorption. Weight loss is achieved both through restriction of food consumption and malabsorption, which results in very good long-term weight loss maintenance.
This surgery is mainly intended for patients with a body mass index (BMI) of 35 or greater. Due to its complexity and increased risks, the single anastomosis duodenal switch should only be performed by a highly experienced bariatric surgeon.
Dr. Alejandro Lopez‘s private practice; ALO Bariatrics, has been recognized by the Mexican College of Surgery for Obesity and Metabolic Diseases as a Center of Excellence, with a very high patient success rate for said procedure.
Dr. Alejandro Lopez is a board certified surgeon who’s received advanced fellowship training in weight loss surgery at Cook County Hospital in Chicago, Illinois. He has broad experience in laparoscopic surgery and extensive operating room technical expertise for bariatric procedures, including laparoscopic gastric bypass, single anastomosis duodenal switch, sleeve gastrectomy, bariatric revision procedures, as well as gastric plication.
One reason that good long-term weight loss has been reported with the duodenal switch with single anastomosis is likely due to a dramatic decrease in the appetite-producing hormone known as ghrelin. The tissue that produces the hormone is almost completely removed with the stretchy outer portion of the stomach. Patients typically report a significant decrease in hunger and food consumption after this operation. In addition, re-routing the intestines helps bring food to the lowest portion of the small intestines earlier than usual which releases important appetite-suppressing hormones such as polypeptide YY (PYY) and glucagon-like peptide 1 (GLP1). This may explain the superior weight loss, weight maintenance and diabetes resolution associated with this surgery.
The Single Anastomosis Duodenal Switch is inarguably associated with the greatest weight loss and remission of diabetes of any bariatric metabolic procedure.
- Approximately 90-95% excess weight loss (EWL) has been reported.
- Improvement/resolution in all major co-morbidities, in 95% of patients there’s a temporary resolution of type 2 diabetes, sleep apnea, hypertension, high cholesterol and depression.
- There is very little risk of “dumping” syndrome-which occurs when a patient consumes sugar or carbohydrates, or eats too quickly, causing nausea, cramping, diarrhea, sweating, vomiting and heart palpitations. Preservation of the pyloric valve provides for a more physiologic emptying of solid foods from the stomach enabling people to tolerate normal foods and reducing dumping syndrome.
- This is a pill-friendly operation. NSAIDS and Aspirin are well tolerated.
- Because weight loss is achieved through stomach restriction as well as malabsorption, this surgery typically provides very predictable weight loss with great long-term weight loss maintenance.