• ER Wait Times

    Emergency Room Wait Time
    ER wait times explained

    48 Minute(s)

    Newton-Wellesley Hospital

    2014 Washington Street

    Newton, MA 02462

    617-243-6000

    Walk-In Wait Time

    Newton-Wellesley Hospital Waltham Walk-In

    Hours and Directions
    In case of emergency call 9-1-1

      Wait times are approximate and subject to change

    Should I go to Urgent Care or the Emergency Room to treat my medical problem?
  • Patient Gateway Login
  • Patient Gateway Login
  • Giving
  • Careers
  • Contact

Need to talk to us?

Call 617-243-6000
  • Physicians
  • Locations
  • Specialties
  • Patients & Visitors
  • Search
  • More
  • Walk-in Clinics
  • About Us
  • Careers
  • Classes & Community Resources
  • Healthcare Professionals
  • Nursing Department
  • News
  • Research
  • Volunteer

What can we help you find?

Need help finding a doctor?

Call 617-243-6566 or toll free 866-NWH-DOCS to speak to a CareFinder representative.

Newton-Wellesley Hospital

2014 Washington Street

Newton, MA 02462

617-243-6000

Open 24 hours
Lab Hours and Holiday Hours Vary
 

Get Directions | View Hours

Ambulatory Care Center - Natick

307 W Central St

Natick, MA 01760

617-243-5345

Get Directions | View Hours

Ambulatory Care Center - Newton

159 Wells Ave

Newton Centre, MA 02459

617-243-5777

Get Directions | View Hours

Ambulatory Care Center - Walpole

111 Norfolk Street

Walpole, MA 02081maps

617-243-5345

Get Directions | View Hours

Ambulatory Care Center – Wellesley

978 Worcester Road (rte 9)

Wellesley, Massachusetts 02482

781-235-5200

Get Directions | View Hours

Maxwell Blum Emergency Pavilion

2014 Washington Street

Newton, MA 02462

617-243-6000

Open 24 hours

Lab Hours and Holiday Hours Vary

Get Directions | View Hours

Outpatient Surgery Center - Wellesley

25 Washington Street

Wellesley, Massachusetts 02481

617-219-1520

Get Directions | View Hours

Waltham Walk-In

9 Hope Ave

Waltham, MA 02453

617-243-5590

Monday through Saturday: 9:00 am to 7:00 pm

Sunday: 9:00 am to 2:00 pm

Lab Hours and Holiday Hours Vary

Get Directions | View Hours

Our Locations

  • Newton-Wellesley Hospital
  • Ambulatory Care Center - Natick
  • Ambulatory Care Center - Newton
  • Ambulatory Care Center - Walpole
  • Ambulatory Care Center – Wellesley
  • Emergency Department
  • Outpatient Surgery Center - Wellesley
  • Waltham Walk-In
View All Locations

Our Specialties

  • Cancer Care
  • Cardiovascular
  • Heartburn and Reflux
  • Maternity
  • Orthopedics
  • Pediatrics
  • Primary Care
  • Robotic Surgery
  • Weight Loss
  • Women's Health

Browse A-Z

  • A
  • B
  • C
  • D
  • E
  • F
  • G
  • H
  • I
  • J
  • K
  • L
  • M
  • N
  • O
  • P
  • Q
  • R
  • S
  • T
  • U
  • V
  • W
  • X
  • Y
  • Z
  • Breast Health Center
  • Orthopedic Walk-In

  • Cancer Care
  • Pediatrics

  • Cardiology
  • Primary Care

  • Dermatology
  • Psychiatry

  • Emergency Medicine
  • Radiology

  • Gastroenterology
  • Rehabilitation

  • Infectious Diseases
  • Spine Center

  • Joint Center
  • Sports Medicine

  • Labs
  • Surgery

  • Medicine
  • Urology

  • Neurosurgery
  • Vascular Surgery

  • Obstetrics and Gynecology
  • Walk-In Clinic

  • Orthopedics
  • Weight Management
  • View All
Duodenal Switch Procedure
Request an Appointment
or call us 617-243-3724

Section Menu

  • Welcome
  • About Us
    • Meet the Team
    • Awards & Recognition
    • Frequently Asked Questions
    • Contact Us / Appointments
  • Obesity Facts
    • Causes of Obesity
    • How Obesity Affects Health
  • Treatment Options
    • Sleeve Gastrectomy
    • Roux-en-Y Gastric Bypass
    • Gastric Band Removal
    • Gastric Band Conversion
    • Duodenal Switch Procedure
    • Cosmetic Procedures After Surgery
  • Patient Resources
    • Making the Decision
    • Support Groups
    • Nutrition 101
    • Helpful Links
  • Success Stories
    • Andrea's Story
    • Ann's Story
    • Aubrey's Story
    • Craig's Story
    • Jeff's Story
    • Jen's Story
    • John's Story
    • Marty's Story
    • Ryan's Story
    • Steve's Story

Duodenal Switch 

 

A duodenal switch procedure is also known as biliopancreatic diversion with a duodenal switch, or BPD-DS. This procedure is more complex than other types of weight loss surgery, and it is less common.

A duodenal switch involves two surgical procedures.

  • The first procedure is similar to gastric sleeve surgery, in which a large portion of your stomach is removed.
  • The second procedure redirects food so that it bypasses most of your small intestine. The bypassed section is reattached to the last part of your small intestine to allow digestive juices to mix with food.

This type of surgery may allow more weight loss, but it is also the most likely to cause surgery-related problems and vitamin or mineral deficiencies. For that reason, this procedure is generally recommended for people with a body mass index (BMI) greater than 50.

Single-Anastomosis Duodenal Switch

SIPS- DS or Loop- DS

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.

The gastric sleeve is created as a primary operation to achieve some weight loss and health improvement. Then typically a year after laparoscopic sleeve gastrectomy, patients who still have a BMI > 40, significant medical comorbidities and those who need an additional metabolic push, will proceed to the second laparoscopic operation to complete the SIPS-DS procedure.

The SIPS procedure is performed after the lap sleeve gastrectomy by bypassing roughly half of the upper small intestine, resulting in a moderate decrease in calorie absorption and powerful gut chemistry changes to effect metabolism. Weight loss is achieved through restriction of food consumption, metabolic change and some malabsorption, which results in very good long-term weight loss maintenance.

The SIPS-DS procedure will re-route the intestines so that calorie absorption is moderately reduced.

The duodenum (the first section of the small intestine) is transected after the pylorus. Rather than transecting the lower intestines (as is done with the standard duodenal switch), the surgeon simply attaches the small intestine at a point approximately 8-10 feet or 250-300 cm from the colon to the duodenal stump just beyond the pyloric valve. This creates a loop that diverts the food stream from the top half of the small intestines.

The top half of the intestine now carries just digestive juices (bile and pancreatic juices), and is called the bilio-pancreatic limb (BPL). The last segment of the intestine where the food and digestive juices mix is referred to as the common channel (CC).

Absorption of nutrients and calories is determined by the length of the common channel, so a shorter channel helps decrease the chance of weight regain by decreasing calorie absorption.

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 outer portion of the stomach during the sleeve gastrectomy operation. 

Patients typically report a significant decrease in hunger and food consumption after this first stage 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 polypeptideYY (PYY) and glucagon-like peptide 1 (GLP1). This may explain the superior weight loss, weight maintenance and diabetes resolution associated with this surgery.

Outcomes:

  • Approximately 70% excess weight loss (EWL) has been reported. (Excess weight is the amount of weight over what is considered the “ideal body weight” for a person’s height [Current Weight – Ideal Weight = Excess Weight]. The percentage of excess weight loss (%EWL) is the percentage of weight loss from this excess weight.)
  • Improvement/resolution in all major co-morbidities, including 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, metabolic changes, as well as malabsorption, this surgery typically provides very predictable weight loss with great long-term weight loss maintenance.
  • Although patients report experiencing less malabsorptive symptoms compared to a standard duodenal switch because the common channel length is almost twice that of a standard DS, it is important to take vitamin supplements life-long to avoid nutritional deficiency and more frequent bowel movements should be expected.

Call us at 617-243-3724 to request an appointment.

Let us help you find your perfect doctor.

Call 866-694-3627 or Get help from our carefinder team

Newton-Wellesley Hospital

2014 Washington Street
Newton, MA 02462
Get Directions
617-243-6000

Stay Connected!

Contact Us

Quick Links

CareersCommunity ResourcesDoctorsLocationsMedical & Surgical Services Patients & Visitors Site Map
Mass General Brigham
Legal Statements | HIPAA Guidelines | Website Privacy | Website Disclaimer

We use cookies and other tools to enhance your experience on our website and to analyze our web traffic. For more information about these cookies and the data collected, please refer to our Privacy Policy.

×