Duodenal Switch

(DS, BPD-DS, Biliopancreatic Diversion-Duodenal Switch)

SADI/SIPS/Loop Duodenal Switch

The Duodenal Switch has been around since the 1980’s. It combines a restrictive component, just like the sleeve, with a malabsorptive component, like a gastric bypass. One of the advantages of the Duodenal Switch is preservation of the pylorus (the valve at the bottom of the stomach). This both minimizes dumping and prolongs the amount of time food stays in the stomach. Thus effectively giving a longer sensation of fullness, or satiety. Another advantage is that the type of bypass performed in a DS (duodenum to ileum), significantly limits the amount of fat that is absorbed from the diet. Additionally, the malabsorptive component of the DS is fully reversible, as the small intestine is re-routed, not removed.

Dr. Metz is the first bariatric surgeon in the region to offer the Laparoscopic Duodenal Switch!


  • Better long term weight loss than any of the other available bariatric procedures
  • 98.9% resolution of type 2 diabetes
  • 99% resolution of hyperlipidemia (high cholesterol)
  • 92% resolution of sleep apnea
  • 83% resolution of hypertension (high blood pressure)


  • Vitamin and mineral deficiencies and protein calorie malnutrition—easily avoided by taking supplements
  • Foul-smelling stools and flatulence, occasional diarrhea—minimized by reducing fat intake
  • Gall stones—can occur after any form of weight loss surgery

Other thoughts:

The Loop DS is an even safer form of the traditional DS. We bring up a loop of small intestine, rather than dividing and re-routing other sections of intestine. The Loop modification significantly reduces the risk of internal hernia (when intestine herniates between new connections of the small bowel). It also reduces the risk of leak due to the decreased number of intestinal connections that are created. The loop DS does not carry the same risk as other loop-type procedures. This is due to the preservation of the pylorus. The valve at the bottom of the stomach prevents the bile reflux associated with other types of loop bypasses.

Ask us if Duodenal Switch weight loss surgery is right for you