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Updated: Jul 17, 2025
Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy Model in Mice
Published on: February 10, 2023
Initial experience with laparoscopic revisional single anastomosis duodeno-ileal bypass (SADI-S) after failed sleeve
Michał Wysocki1, Maciej Borys1, Dorota Budzyńska1
1Department of General Surgery and Surgical Oncology, Ludwik Rydygier Memorial Hospital, Krakow, Poland.
Introduction:
Laparoscopic sleeve gastrectomy (SG) is currently the most commonly performed bariatric operation, but re-do surgery may be necessary in up to half of the patients. Single anastomosis duodeno-ileal bypass (SADI-S) is quickly gaining recognition as a revisional procedure after failed SG.
Aim:
To discuss the surgical technique and analyze initial outcomes after introduction of SADI-S after SG with 1-year follow-up.
Material And Methods:
This is a retrospective cohort study of consecutive patients who underwent re-do bariatric surgery - revisional SADI-S - in 2021 at a secondary referral public hospital. All patients' follow-up was completed 1 year after.
Results:
14 consecutive patients, 6 (43%) males and 8 females, were included. Median maximal body mass index (BMI) was 52.29 (47.96-77.16) kg/m2, BMI before SADI-S was 43.09 (41.64-48.99) kg/m2. No perioperative morbidity was recorded. Four (28%) patients reported recurrent abdominal crampy pain and diarrhea that required dietary advisement and pharmacological therapy in the postoperative period. No reoperations, mortality or readmissions were recorded during 1-year follow-up. SADI-S was associated with further weight loss, resulting in median BMI of 37.55 (36.29-39.43) kg/m2 1 year after SADI-S. Observed additional percentage total weight loss (%TWL) 1 year after SADI-S was 18.65% (17.25-21.89%), while additional percentage excess body mass index loss (%EBMIL) was 35.88% (29.18-41.92%). There was 1 case of diabetes mellitus type 2 remission and improvement in glycemic control in 1 patient. 4/6 patients (66.67%) had improvement in control of hypertension.
Conclusions:
SADI-S is promising re-do surgery after SG with low postoperative morbidity. Additional %TWL 1 year after SADI-S is ~19%, while additional %EBMIL is ~36%, with significant improvement of obesity-related comorbidities.
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