Biliopancreatic Diversion with Duodenal Switch (DS) continues to be a relatively rarely performed bariatric operation worldwide despite the availability of robust long-term outcomes data as well as data comparing DS to other procedures. The current increase in the frequency of sleeve gastrectomy and the recent modifications of the DS technique (single anastomosis) have sparked a renewed interest in DS, particularly as a revisional surgical option. The target audiences of this course are programs and surgeons who are considering adding DS to their bariatric practice as well as those who currently perform DS and wish to learn about new approaches to technique and nutritional management.


  • Provide an update on the current understanding of DS physiology and mechanism of action.
  • Summarize the data on the impact of DS on bowel function and quality of life.
  • Describe the nutrition management strategies specific to DS.
  • Describe aspects of surgical technique specific to DS to potentially improve outcomes and reduce complications, including single-anastomosis and limb-length adjustment.
  • Summarize an evidence-based framework for DS as a primary and a revisional bariatric procedure.
  • Describe programmatic strategies to improve long-term follow-up and outcomes.
  • Introduce key considerations with regards to DS coding and reimbursement.

8:00am Duodenal Switch in 2016
Vivek Prachand, MD
8:10am How malabsorptive is DS? Limb lengths and quality of life
Laurent Biertho, MD
8:25am Role of the sleeve and pylorus in DS
Mitchell Roslin, MD FASMBS
8:40am Nutritional management after DS
Alfons Pomp, MD
8:55am Optimizing long-term outcomes and follow-up
Karen Schulz, CNS
9:05am Loop DS: Rationale and Outcomes
Antonio Torres, MD PhD
9:20am Q & A
9:30am Break
9:45am Mini-Debate: Is Loop DS an investigational procedure? Yes
Stacy A. Brethauer, MD MPH FACS
9:45am Mini-Debate: Is Loop DS an investigational procedure? No
Vivek Prachand, MD
10:00am Technique: Duodenal dissection and transection
Mustafa Hussain, MD
10:10am Hand-sewn duodenoileostomy
Dana Portenier, MD
10:20am Robotic-assisted duodenoileostomy
Ranjan Sudan, MD FASMBS
10:30am Stapled duodenoileostomy
Peter Ng, MD
10:40am Mesenteric defect closure
Laurent Biertho, MD
10:50am Q & A
11:00am DS after sleeve gastrectomy: strategies and decision-making
Michel Gagner, MD
11:15am DS after RYGB: when and how?
Daniel R. Cottam, MD
11:30am Coding the Duodenal Switch
Matthew Brengman, MD FASMBS
11:45am Q & A
12:00pm Adjourn