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Single Anastomosis Duodenoileostomy with Sleeve: A Comprehensive Review of Anatomy, Surgical Technique, and Outcomes

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Abstract

Purpose of Review

Single anastomosis duodenoileal bypass with sleeve (SADI-S) is a recently endorsed metabolic and bariatric surgery (MBS) procedure in the US. Despite its favorable characteristics, the utilization of SADI-S remains limited, accounting for a mere 0.25% of all MBS procedures performed. This review aims to offer an updated examination of the technique, while also presenting the safety and outcomes associated with SADI-S on both the short and long term.

Recent Findings

The safety of SADI-S is well-established, with short-term complication rates as low as 2.6%. A common channel length of 300 cm has consistently shown a lower incidence of malabsorption complications compared to shorter lengths. Bile reflux after SADI-S is relatively rare with an incidence of only 1.23%. SADI-S demonstrated sustained total weight loss (%TWL) at 5 years (37%) and 10 years (34%) postoperatively. Resolution of weight-related medical conditions was also significant after SADI-S, with remission rates of diabetes mellitus as high as 86.6% with over 5 years of follow-up.

Summary

SADI-S is a safe and effective MBS procedure that has shown impressive and sustainable results in terms of weight loss and improvement in obesity-related medical conditions. Careful limb length selection is essential in minimizing the risk of nutritional deficiencies. SADI-S holds great promise as a valuable option for individuals seeking effective weight loss and improvement in associated health conditions.

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Authors and Affiliations

  1. Department of Metabolic and Abdominal Wall Reconstructive Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Kamal Abi Mosleh, Amanda Belluzzi, Mohammad Al-Kordi, Karl Hage & Omar M. Ghanem

  2. Division of Pediatric Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Noura Jawhar

  3. Department of Surgery, Carle Foundation Hospital, Champaign, IL, USA

    Katie Marrero

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  1. Kamal Abi Mosleh
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  2. Amanda Belluzzi
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Contributions

All authors contributed to the study conception and design. The literature review was done by Kamal Abi Mosleh, Amanda Belluzzi, Noura Jawhar and Mohammad Al-Kordi. The original draft preparation was done by Kamal Abi Mosleh, Amanda Belluzzi, Noura Jawhar and Katie Marrero. The reviews and editing were done by Kamal Abi Mosleh, Amanda Belluzzi and Karl Hage. Omar M. Ghanem supervised the project and provided valuable input to its conduction.

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Correspondence to Omar M. Ghanem.

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Kamal Abi Mosleh, Amanda Belluzzi, Noura Jawhar, Katie Marrero, Mohammad Al-Kordi, Karl Hage and Omar M. Ghanem have no relevant financial or non-financial interests to disclose.

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Abi Mosleh, K., Belluzzi, A., Jawhar, N. et al. Single Anastomosis Duodenoileostomy with Sleeve: A Comprehensive Review of Anatomy, Surgical Technique, and Outcomes. Curr Obes Rep 13, 121–131 (2024). https://doi.org/10.1007/s13679-023-00535-y

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