Patient selection: Nowadays with the availability of the SADI bypass the duodenal switch has lost its ground as the weight loss is similar but the SADI has a lowered chance on an internal hernia.
Procedure: In these procedures a big stomach pouch or sleeve is created and connected with the small bowel in order to bypass the remaining part of the stomach using two intestinal reconnections.
Result: Long-term average over-weight loss around 80-85% and is effective for those who love sweets (fizzy drinks, chocolate, ice cream, chips, etc.). Big advantage in comparison to the mini-bypass is that in the SADI the connection is made after the stomach, thus reducing the chance on biliary reflux.
Disadvantage: The stools are likely a bit softer leaking to have stools two times a day. Moreover, as this is a strong malabsorptive procedure it is very important to take vitamins and proteins postoperatively is important.