Laparoscopic BPD with Duodenal Switch

Laparoscopic Biliopancreatic Diversion (BPD) with Duodenal Switch (DS) surgery is another malabsorptive surgical weight loss option we offer at AtlantiCare. The BPD with DS was first reported by Dr. Doug Hess in 1986 and is considered the most effective surgical weight loss approach available today. It is also the most effective treatment for metabolic diseases, such as Type 2 Diabetes and hyperlipidemia associated with morbid obesity. The procedure has both restrictive and malabsorptive components. Very few centers in the world offer this procedure, especially with a laparoscopic approach.

Patients who choose to have laparoscopic BPD with duodenal switch surgery will typically experience these benefits:

  • Increased amount of food intake compared to the bypass and band and yet with the greatest weight loss
  • Less food intolerance
  • Possibly greater long-term weight loss
  • More rapid weight loss compared with gastric banding procedures
  • Decreased or complete remission of health disorders resulting from extreme overweight*, such as:
    • Diabetes (Most patients with Type 2 diabetes experienced complete remission)*
    • High blood pressure
    • Gastric reflux
    • Hyperlipidemia
    • Sleep apnea and other conditions
  • Increased mobility
  • Improved psychological wellness
  • Improved social interactions
  • And, most important, overall improvement in quality of life

*Improvement or complete resolution of medical problems is not guaranteed and they may recur if weight is regained.

What the Procedure Involves

  • Removal of 85% of the stomach including the portion that is responsible for producing an appetite stimulating hormone (Ghrelin). Since this portion is removed, patients tend to feel less hungry than before surgery and yet the functional part of the stomach remains. Formation of the new stomach “sleeve”, which is shaped like a very slim banana which measures from 1-5 ounces.  By reducing the size of usable stomach the patient feels full with lesser amounts of food.
  • The small intestine is reconfigured and then reconnected to the remainder of the stomach so that not all of the calories that are consumed will be absorbed, producing the greatest amount of weight loss of all bariatric surgical options


Long-term follow up and daily vitamin and protein supplements are crucial to the success of this operation. Life-long monitoring is necessary to prevent nutritional and mineral deficiencies – just as with the RYGBP.

The gallbladder, if still present, is removed as a part of the procedure.



Baltasar, A., Bou, R., Bengochea, M., Arlandis, F., Escriva, C., Miro, J., ... & Perez, N. (2001). Duodenal switch: an effective therapy for morbid obesity-intermediate results. Obesity surgery11(1), 54-58.

Pories, W. J. (2005). Cartoon. Surgery for Obesity and Related Diseases1(3), 387.

Topart, P., Becouarn, G., & Ritz, P. (2013). Weight loss is more sustained after biliopancreatic diversion with duodenal switch than Roux-en-Y gastric bypass in superobese patients. Surgery for Obesity and Related Diseases9(4), 526-530.