Abstract
Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-s) is a novel one loop duodenal switch with a 250 cm common limb. A sleeve gastrectomy over a large bore bougie (54 French) is initially performed and the duodenum is transected 2–4 cm from the pylorus. An ileal loop, 250–300 cm from the cecum (initially 200 cm), is ascended antecolically and anastomosed to the duodenum in an end-to-side fashion. Four-hundred and thirty patients have been consecutively operated upon. Mean initial body mass index (BMI) was 48 kg/m2 and 65% of the patients were diabetic. Mean excess weight loss was 90–95%, with only 3% of the patients failing to reach a 50% excess weight loss. Glycemia and HbA1c values normalized in the early postoperative periods, with 85% of the diabetic patients showing levels of HbA1c below 6%. The overall conversion rate for malnutrition is 3.8%, but this fell to 2.3% for patients with a 250 cm common limb and 0% for patients with a 300 cm common limb.
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1 Electronic Supplementary Material
Video 1
This video shows the main steps in performing the SADI-s procedure: Dissection of the antro-pyloric-duodenal area passing a vessel loop behind the duodenum. Sleeve gastrectomy over a large bougie (54 french). Duodeno-ileal anastomosis at 250 cm from the ileo-cecal valve (MOV 90237 kb)
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Torres, A.J., Rubio, M.Á., Sánchez-Pernaute, A., Pérez-Aguirre, E. (2023). Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) Surgery. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-60596-4_47
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DOI: https://doi.org/10.1007/978-3-030-60596-4_47
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