Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: Gastric bipartition, a novel metabolic surgery procedure: A retrospective cohort study

Mahdy, Tarek; wahedi, A. Al; Schou, Carl Fredrik

doi:10.1016/j.ijsu.2016.08.018

Cited by 99 publications

(98 citation statements)

References 37 publications

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“…FPG, low-density lipoprotein (LDL), and insulin use were statistically significantly lessened, while high-density lipoprotein (HDL) was significantly increased [81]. In the single study by Mahdy et al, 50 included patients (mean BMI 48.7 ± 7.6 kg/m 2 ) experienced significant mean weight loss of 90.0% EWL at 1 year, glucose was normalized in 100.0% of patients at 3 months, and all were off insulin and hypoglycemic drugs [80].…”

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

“…Single-Anastomosis Sleeve with Ileal Bypass (Fig. 10) Origin, Advantages The SASI bypass is a modification of the SG-TB of Santoro [68] popularized by Mahdy and colleagues [80]. It combines an SG and loop transit bipartition rather than Roux-en-Y gastroileostomy 300 cm from the ileocecal junction.…”

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

“…Ghrelin secretion is decreased and the flow of food through the gastroileostomy instead of the pylorus is theorized to lessen foregut stimulation and augment hindgut stimulation. Like the SG-TB, the SASI is described as safer and easier to perform than DS and carries the weight-loss benefits without the nutrient deficiencies and protein caloric malnutrition [80]. The duodenum and papilla are endoscopically accessible.…”

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

“…At 6 months, one patient was diagnosed with a marginal ulcer; at 1 year, one patient was reoperated to avert potential excessive weight loss. Patency of the anastomosis and ulceration are potential long-term concerns [80]. SASI may potentially be revised or reversed.…”

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

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Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Bhandari

Fobi

Buchwald³

2019

OBES SURG

114

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Background Standardization of the key measurements of a procedure's finished anatomic configuration strengthens surgical practice, research, and patient outcomes. A consensus meeting was organized to define standard versions of 25 bariatric metabolic procedures. Methods A panel of experts in bariatric metabolic surgery from multiple continents was invited to present technique descriptions and outcomes for 4 classic, or conventional, and 21 variant and emerging procedures. Expert panel and audience discussion was followed by electronic voting on proposed standard dimensions and volumes for each procedure's key anatomic alterations. Consensus was defined as ≥ 70% agreement. Results The Bariatric Metabolic Surgery Standardization World Consensus Meeting (BMSS-WOCOM) was convened March 22-24, 2018, in New Delhi, India. Discussion confirmed heterogeneity in procedure measurements in the literature. A set of anatomic measurements to serve as the standard version of each procedure was proposed. After two voting rounds, 22/25 (88.0%) configurations posed for consideration as procedure standards achieved voting consensus by the expert panel, 1 did not attain consensus, and 2 were not voted on. All configurations were voted on by ≥ 50% of 50 expert panelists. The Consensus Statement was developed from scientific evidence collated from presenters' slides and a separate literature review, meeting video, and transcripts. Review and input was provided by consensus panel members. Conclusions Standard versions of the finished anatomic configurations of 22 surgical procedures were established by expert consensus. The BMSS process was undertaken as a first step in developing evidence-based standard bariatric metabolic surgical procedures with the aim of improving consistency in surgery, data collection, comparison of procedures, and outcome reporting.

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Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

Section: Indications/contraindications Weight Loss Diabetesmentioning

confidence: 99%

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Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Bhandari

Fobi

Buchwald³

2019

OBES SURG

114

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“…Sleeve gastrectomy with loop gastroileal bypass (SG LGIB; Fig. 1) is technically a modification of SADI S. It is very similar to sleeve gastrectomy with loop bipartition 13 or single-anastomosis sleeve ileal (SASI) bypass, 14 but with a few technical variations. SG LGIB is a simple operation in which sleeve gastrectomy is performed and ileum 300 cm proximal to ileocecal junction is anastomosed in a loop fashion to the pyloric antrum.…”

mentioning

confidence: 99%

A Feasibility Study of Novel “Laparoscopic Sleeve Gastrectomy with Loop Gastroileal Bypass” for Obesity: An Indian Experience

Vennapusa¹,

Panchangam²,

Madivada³

2017

International Surgery

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Objective: This study is aimed to evaluate the safety, feasibility, and efficacy of a novel technique: laparoscopic sleeve gastrectomy with loop gastroileal bypass. Summary of Background Data: Standard bariatric surgeries, such as sleeve gastrectomy and Roux-en-Y gastric bypass, although very effective, carry certain inherent limitations and inevitable sequelae. Newer bariatric/metabolic surgeries are required to address these limitations. Methods: Between February 2016 and February 2018, a total of 113 Indians suffering from obesity with or without type 2 diabetes underwent sleeve gastrectomy with loop gastroileal bypass. Meticulous analysis of prospectively documented data was performed. Results: Mean age was 40.74 ± 10.4 years, mean body mass index was 43.48 ± 7.57 kg/m2. A total of 54 of 113 patients (47.79%) had type 2 diabetes. Mean duration of surgery was 148.36 ± 38.56 minutes. Common channel length was 250 cm in 18 patients, 300 cm in 88 patients, and 350 cm in 7 patients. There were no major complications, such as major intra-abdominal bleeding, perforation, or leak. According to Indian standards, when 23 kg/m2 was taken as a cutoff upper limit for normal weight, percentage of excess weight loss was 25.04% ± 10.13%, 67.81% ± 23.17% and 94.33% ± 24.96%, respectively, at 1, 6, and 12 months after surgery. A total of 51 of 54 patients with type 2 diabetes stopped using antidiabetes medications within 1 week after surgery. Conclusion: Laparoscopic sleeve gastrectomy with loop gastroileal bypass appears to be a promising procedure to address limitations associated with standard bariatric procedures.

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Magnetic single‐anastomosis side‐to‐side duodeno‐ileostomy for revision of sleeve gastrectomy in adults with severe obesity: 1‐year outcomes

Gagner,

Almutlaq,

Gnanhoue

et al. 2024

World j. surg.

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IntroductionUncomplicated surgical approaches that minimize anastomotic complications while improving revisional metabolic/bariatric surgical (MBS) outcomes are needed.MethodsThis prospective single‐center study assessed the feasibility, safety, and efficacy of the novel linear magnetic anastomosis system (LMAS [3 cm]) in performing a side‐to‐side duodeno‐ileostomy (MagDI) bipartition to revise clinically suboptimal primary sleeve gastrectomy (SG). Patients with severe obesity with/without type 2 diabetes (T2D) with suboptimal weight loss, regain, and/or T2D recurrence post SG underwent revisional MagDI. A distal and proximal magnet were delivered endoscopically to the ileum and duodenum and aligned via laparoscopic assistance. Gradual magnet fusion formed a DI bipartition. Primary endpoints: technical feasibility, safety (Clavien‐Dindo [CD] severe adverse event classification) at 1 year. Secondary endpoints: MBS weight and T2D reduction.ResultsJuly 29, 2022–March 28, 2023, 24 patients (95.8% female, mean age 44.9 ± 1.5 years, and body mass index [BMI] 39.4 ± 1.3 kg/m2) underwent MagDI. Feasibility was attained via correct magnet placement (mean operative time 63.5 ± 3.3 min), patent anastomoses created, and magnet passage per anus in 100.0% of patients. There were 4 CD‐III mild or moderate severe AEs, 0.0% associated with the LMAS or MagDI: 0.0% anastomotic leakage, obstruction, bleeding, infection, reintervention, or death. Mean BMI reduction was 2.1 kg/m2 (p < 0.05); total weight loss 5.3%, excess weight loss 16.4%; and the patient with T2D improved.ConclusionThe single‐anastomosis MagDI procedure using the novel 3‐cm LMAS to revise clinically suboptimal SG was technically straightforward, incurred no major complications, mitigated weight regain, and renewed clinically meaningful weight loss.Clinicaltrials.gov IdentifierNCT05322122.

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Efficacy of single anastomosis sleeve ileal (SASI) bypass for type-2 diabetic morbid obese patients: Gastric bipartition, a novel metabolic surgery procedure: A retrospective cohort study

Abstract: SASI bypass is a promising operation that offers excellent weight loss and diabetic resolution.

Cited by 99 publications

References 37 publications

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

Standardization of Bariatric Metabolic Procedures: World Consensus Meeting Statement

A Feasibility Study of Novel “Laparoscopic Sleeve Gastrectomy with Loop Gastroileal Bypass” for Obesity: An Indian Experience

Magnetic single‐anastomosis side‐to‐side duodeno‐ileostomy for revision of sleeve gastrectomy in adults with severe obesity: 1‐year outcomes

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