Laparoscopic SADI-S as a salvage procedure for failed gastric bypass and sleeve gastrectomy: How I do it

Abstract

Malabsorptive procedures such as duodenal switch (DS) and biliopancreatic diversion are extremely effective bariatric operations, yet account for<1.5% of all bariatric procedures performed worldwide at present [ [1] Angrisani L. Santonicola A. Iovino P. Formisano G. Buchwald H. Scopinaro N. Bariatric Surgery Worldwide 2013. Obes Surg. 2015; 25: 1822-1832 Crossref PubMed Scopus (1063) Google Scholar ]. Reasons for such low volume include perceived technical complexity of these operations and concerns for major postoperative complications including severe nutritional deficiencies. The single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a modification of the standard DS procedure, which can achieve equivalent clinical benefit but with less associated risk of postoperative nutritional complications [ 2 Sanchez-Pernaute A. Herrera M.A. Perez-Aguirre M.E. et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010; 20: 1720-1726 Crossref PubMed Scopus (146) Google Scholar , 3 Sanchez-Pernaute A. Rubio Herrera M.A. Perez-Aguirre E. et al. Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007; 17: 1614-1618 Crossref PubMed Scopus (132) Google Scholar , 4 Sanchez-Pernaute A. Rubio M.A. Cabrerizo L. Ramos-Levi A. Perez-Aguirre E. Torres A. Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) for obese diabetic patients. Surg Obes Relat Dis. 2015; 11: 1092-1098 Abstract Full Text Full Text PDF PubMed Scopus (99) Google Scholar , 5 Gebelli J.P. Gordejuela A.G. Ramos A.C. et al. Sadi-S with right gastric artery ligation: technical systematization and early results. Arq Bras Cir Dig. 2016; 29: 85-90 Crossref Google Scholar ].