[First SADI-S in the Mexican Institute of Social Security]

Sleeve gastrectomy is the most frequently performed bariatric surgery, however several patients did not achieve satisfactory weight loss or suffer of weight regain. The SADI-S has been proposed as an acceptable revision surgery with good results and low complications rate. Our objective is to present the first case of SADI-S performed in the Mexican Institute of Social Security as surgical revision after sleeve gastrectomy for weight regain.

A 50-year-old man presented with a history of type 3 obesity (weight 167 kg, BMI 48.8), hypertension, dyslipidemia, and obstructive sleep apnea, summited to sleeve gastrectomy on 2019 with weight regain of 49.5 % of excess weight lost in 2 years (weight 156 kg, BMI 45.6, %EWL 13.5 %), so we decided to perform a SADI, with preoperative weight 138 kg and BMI 40.3 kg/m2. The surgery occurred without complications, and he was discharged on postoperative day 2. At six months of follow-up continue with satisfactory weight loss (% EWL 52%), comorbidities remission, asymptomatic and laboratory tests without data of malnutrition or anemia.

The SADI-S seems to be the best option for revisional surgery after sleeve gastrectomy for unsatisfied weight loss or weight regain, so it was the procedure of choice in our case with satisfactory outcomes. We consider the SADI-S as a secure and efficient option for patients with resistance to weight loss.