Duodenal Switch Operation and Stomach Intestine Sparing Surgery (SIPS)

SIPS Procedure

Duodenal Switch

SIPS Procedure

SIPS Procedure

Stomach Intestine Sparing Surgery – known as SIPS for short – is a procedure that involves a sleeve gastrectomy being performed to reroute the small intestine. SIPS weight loss surgery produces malabsorption to effect weight loss. It also produces good control for diabetes – greater than 95% – and other obesity-related illnesses. A variation of this procedure is called duodenal switch surgery. Both of these procedures are performed in our Perth clinic by Mr Siva Gounder.

Duodenal switch Weight Loss Surgery is a very effective technique to facilitate weight loss in obese patients. It has been performed globally for over a decade with good long-term outcomes. This type duodenal switch operation consists of two components – restrictive and a malabsorption.

The SIPS procedure is like the mini- gastric bypass version of the duodenal switch. It is done with one anastomosis and relies on malabsorption, but not the restrictive component.

The restrictive aspect of this type of weight loss surgery involves the removal of more than two-thirds, roughly 70%, of the stomach and much of the duodenum along the main curvature of the stomach. This part of the surgery is irreversible since the stomach is being surgically removed.

The Malabsorption involves surgically re-routing the small intestine to create two separate paths within the digestive tract for food to be absorbed and bile to travel from the liver. This ‘splitting’of what is a common pathway causes two loops to be created. The digestive loop is responsible for ensuring food is delivered to the appropriate parts of the digestive system so the patient is well-nourished, and the second loop is known as the biliopancreatic – responsible for bile being delivered from the liver.

A Duodenal switch procedure (otherwise known as ds weight loss surgery) is effective because it reduces the body’s ability to absorb the calories in the food that has been consumed because the digestive tract has been significantly shortened.

This occurs because bile delivered from the liver and food within the small intestine do not have a chance to ‘mix’ and facilitate this process before entering into the large intestine.

As a weight loss surgery, SIPS surgery or ds surgery is a very effective tool against tackling weight loss in obese or morbidly obese patients. However, as with all weight loss surgery, it needs to be addressed on several fronts for long-term success to be achieved. Patients who undergo a complicated procedure such as a SIPS or duodenal switch surgery and do not adjust their lifestyle accordingly are not likely to see the results they want.

It is recommended that a consultation with Mr Siva Gounder at one of our surgeries based in Perth be the first step should you be considering this type of surgery.

Mr Gounder has performed many of these surgeries and can explain in detail the advantages and the disadvantages of such a surgical procedure. Both of these factors not-withstanding, it is vitally important that a patient actively seek to change their lifestyle to compliment the surgery.

This means consulting with dieticians, and perhaps even a personal trainer to help develop healthy habits and the appropriate mindset to maintain a healthy body weight and eliminate the need for any revisional surgery.

At our Perth clinic, we have several experts who can consult with you on the best way to manage your lifestyle post-surgery so you achieve the best possible results long-term and improve your quality of life.

The SIPS procedure is relatively new compared with ds surgery and thus does not have the same volume of data to compare results against long-term benefits.


Significant weight loss can be achieved using these procedures, in some cases in-excess of 80-90% of a person’s body weight can be lost if the correct lifestyle changes are adhered to post-surgery. Again, our experts at our Perth clinic can help you understand exactly what that process looks like.

Patient’s suffering from diabetes can often see high remission rates once they have managed to get their weight under control and stable

There is zero, or very low incidence of dumping syndrome (dumping syndrome occurs when food enters the digestive tract largely undigested because it has passed through the stomach too fast)

Minimal risk of ulceration at the new joint (anastomosis)


There is a natural increase in malabsorption since this is the intention of the procedure. The body is limited in the amount of vitamins, minerals and calories it can absorb from food. So whilst it limits the ‘bad’ absorption, it also limits the ‘good’ too

Because of this fact, an there is an increased requirement of dietary supplements, such as vitamins that need to be taken to account for this lack of the body naturally absorbing from food.

This procedure does require close, long term follow up, which can be done at our Perth clinic.

There is a very small (2 to 5%) chance of needing revisional surgery for malabsorption. Again this can take place in our Perth Surgery.

There is a slight risk of developing internal hernia and bowel obstructions. This risk is between 2-4%.

Fat malabsorption can result in frequent loose stools, abdominal cramping, and foul-smelling flatulence