Biliopancreatic Diversion obesity surgery was first performed by Nicola Scopinaro, which is why it is still sometimes called the “Scopinaro” procedure.
In the original version the main body of the stomach is removed leaving a small pouch, which gives the restrictive element of the procedure. Then by cutting and re-routing the small intestine, two “limbs” are created. The bypassed section is called the bilio-pancreatic limb through which digestive juices pass. The other limb of small bowel – joined to the stomach pouch – is called the alimentary limb.
Food moves from the small stomach pouch and passes through the alimentary limb largely undigested. It is only when food reaches the common channel where it mixes with digestive juices from the biliopancreatic limb, that absorption of nutrients (and calories) can take place. Hence by shortening the digestion process, the body is not able to fully absorb all of the calories and nutrients from the ingested food, resulting in weight loss. The gallbladder is usually removed during the procedure.
The length of the common channel can be varied depending on the weight of the patient, but is usually between 80cm to 150cm. Once the food residue moves from the common channel into the large bowel, absorption of nutrients and calories takes place.
Although the BPD obesity surgery procedure is still performed, it has largely been replaced with a variation known as Bilio-Pancreatic Diversion with Duodenal Switch (BPD-DS) or just “Switch” for short. The Duodenal Switch provides many of the benefits of the BPD but with fewer unwanted effects. Nevertheless the principles involved are exactly the same.
