Revision of Sleeve to a Duodenal Switch

Conveniently located to serve the areas of Houston and Katy

Gastric Sleeve to Duodenal Switch

Robotic revision of a sleeve to a duodenal switch is a revisional bariatric surgery. The  sleeve procedure has become the most popular bariatric operation because it is a surgery with overall fewer complications than for example, a gastric bypass. However, this operation has its limitations and overtime the sleeve gastrectomy may require a revision.  

At Texas Endosurgery, Dr. R.M. Bonnor M.D, F.A.C.S. specializes in robotic bariatric surgery using the assistance of the Da Vinci Surgical System.  In a robotic assisted revision of a sleeve to a duodenal switch, Dr. Bonnor employs advanced robotic equipment to help  create more consistent and reproducible outcomes.

What is a Duodenal Switch ?

Duodenal switch  is known as a “hybrid procedure” because it combines two strategies for surgical weight reduction: restriction and malabsorption. The popular sleeve is solely a restrictive bariatric surgery. That means the size of the stomach cavity is reduced to decrease volume and therefore control portions. When a sleeve is upstaged to a duodenal switch, an intestinal bypass is created resulting in decreased absorptions of calories but also nutrients.   

Sleeve to Duodenal Switch

At Texas Endosurgery, Dr. Bonnor takes additional measures to reduce risk by employing a high-tech robotic system to assist with surgery.[1]  At your informative consultation, Dr. Bonnor and his knowledgeable staff will help you navigate your weight loss journey. Contact us to schedule an appointment. You can reach us by phone at (281) 579-5638


Duodenal switch is highly efficient in helping patients with obesity reduce their weight. After the procedure, patients will only absorb 30 % of the fat they consume.[2] Duodenal switch may correct health risks that are associated with obesity and therefore increase quality of life and longevity. The procedure provides good weight loss, the lowest risk of weight regain and the best resolution of diabetes. 

Robotically Assisted Surgery

Dr. Bonnor performs safe and effective revisional surgery for the greater Houston area and beyond. Robotically assisted surgery provides a powerful platform to perform complex procedures.  

Personal Consultation

Your personal consultation at Texas Endosurgery is an opportunity to learn about your options for bariatric revision surgery. You can call our Houston offices at (281) 579-5638.


The first part of a duodenal switch surgery (DS)  requires removing 70%  of the stomach to create a sleeve.[3] In a patient with a previous sleeve, Dr. Bonnor will proceed to the next stage of the procedure. This next stage in performing a duodenal switch surgery is the creation of an ”intestinal” bypass as opposed to a “gastric” bypass. This explains why a sleeve may be revised to a duodenal switch (DS) since the sleeve component is the first part of a DS.  


Duodenal switch is superior in correcting diabetes as compared to a sleeve gastrectomy or a gastric bypass. It also addresses high cholesterol or hyperlipidemia more effectively as compared to the other two procedures and there is typically no “dumping syndrome” with a DS.  However, a DS is not as effective for controlling acid reflux disease as compared to a gastric bypass.  

Frequently Asked Questions (FAQ)

How much weight can you lose with a duodenal switch?

Duodenal switch is an extremely effective weight loss surgery because it combines two proven strategies. Duodenal switch is a hybrid procedure that both reduces the size of the stomach and decreases the number of calories that are absorbed by the intestines. Patients can look forward to losing up to 70% or 80% of excess weight following their recovery from duodenal switch. Patients with Type 2 diabetes will see a reduction or complete remission after surgery.

What is the difference between sleeve and duodenal switch?

Duodenal switch surgery actually begins with a sleeve procedure to reduce the size of the stomach. For many bariatric patients, this reduction is enough to jump-start weight loss. But for others, a duodenal switch surgery may be necessary to see improvement in diabetes control and cholesterol level. A duodenal switch takes the additional step of rearranging the intestines so that they absorb fewer calories from food. So, while sleeve is only restrictive, a duodenal switch enhances outcomes by adding a malabsorptive component. 


  1. Bindal, V., Bhatia, P., Dudeja, U., Kalhan, S., Khetan, M., John, S., & Wadhera, S. (2015). Review of contemporary role of robotics in bariatric surgery. Journal of Minimal Access Surgery, 11(1), 16. 
  2. Duodenal Switch As A Revision Surgery – Duodenal Switch. (2020, June 21). Duodenal Switch. 
  3. Sudan, R., & Podolsky, E. (2014). Totally robot-assisted biliary pancreatic diversion with duodenal switch: single dock technique and technical outcomes. Surgical Endoscopy, 29(1), 55–60.