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SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS.
Jordi Pujol Gebelli1, Amador Garcia Ruiz de Gordejuela1, Almino Cardoso Ramos2
1Hospital Universitari de Bellvitge, Barcelona, Spain;
Summary
The SADI-S procedure with right gastric artery ligation is a safe bariatric surgery simplification. This technique shows low complication rates, making it a potentially more popular alternative to traditional duodenal switch operations.
Area of Science:
- Bariatric surgery
- Minimally invasive surgery
- Digestive system surgery
Background:
- Bariatric surgery is globally performed, with Roux-en-Y gastric bypass and sleeve gastrectomy being the most common techniques.
- Biliopancreatic diversion with or without duodenal switch is highly effective but accounts for only 1.5% of procedures due to complexity and risks.
- Fears of technical difficulty, morbidity, mortality, and severe nutritional issues hinder wider adoption of the duodenal switch.
Purpose of the Study:
- To detail the technical aspects and benefits of the single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) with right gastric artery ligation.
- To present SADI-S with right gastric artery ligation as a simplified and effective modification of the original duodenal switch procedure.
Main Methods:
- Analysis of patients who underwent SADI-S with right gastric artery ligation between November 2014 and May 2016.
- Description and analysis of the surgical technique, systematization, and early complications.
- Inclusion of 67 patients (46 female, mean age 44, average BMI 53.5 kg/m2).
Main Results:
- Surgical time averaged 115 minutes.
- A total of 5 patients (7.5%) experienced complications, with 2 (2.9%) requiring reoperation.
- Complications included two leaks (duodenal stump and esophagogastric angle); no mortality was observed.
- Median hospital stay was 2.5 days.
Conclusions:
- SADI-S with right gastric artery ligation is a safe bariatric procedure with a low rate of early complications.
- The technical modifications are reproducible and may increase the popularity of this duodenal switch variation.
- No complications were attributed to the ligation of the right gastric artery.
