Proximal Duodenal–Ileal End-to-Side Bypass with Sleeve Gastrectomy: Proposed Technique

Abstract

Proximal duodenal-ileal end-to-side bypass with sleeve gastrectomy is a new bariatric technique based on the biliopancreatic diversion with duodenal switch in which after the sleeve gastrectomy, the duodenum is anastomosed to the ileum in a Billroth-II fashion. A 200-cm common channel-alimentary limb is devised. Anticipating an appropriate weight loss, at least similar to that obtained after gastric bypass, theoretical benefits for operated patients are a shorter operative time, the performance of only one anastomosis, and no mesentery opening. A prospective trial is now being conducted to find out the results of the procedure and to compare them to those obtained with gastric bypass and standard duodenal switch.

Single Anastomosis Duodeno–Ileal Bypass with Sleeve Gastrectomy (SADI-S). One to Three-Year Follow-up

“…Three years ago, we changed Hess's DS eliminating the Roux-en-Y reconstruction and performing a Billroth II-type one-loop duodeno-ileostomy instead [1]. The Roux-en-Y intestinal reconstruction is a procedure originally developed for two reasons: to prevent tension in a distant anastomosis and to protect the gastric mucosa against pancreato-biliary secretions [11].…”

“…Trying to simplify the surgical procedure, our group developed 3 years ago a new technique, originally based on the duodenal switch (DS), in which only one anastomosis is performed, the "Single Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy" or SADI-S [1] (Fig. 1).…”

The FTO Obesity Gene. Genotyping and Gene Expression Analysis in Morbidly Obese Patients

“…Details of surgical procedures have been previously described [21][22][23]. Also, in 35 of them, additional samples from visceral adipose tissue were obtained.…”

Single-anastomosis duodenoileal bypass with sleeve gastrectomy: metabolic improvement and weight loss in first 100 patients

“…They can offer better weight loss and a greater rate of metabolic improvement [5] in return for a greater rate of protein and vitamin deficiencies than gastric bypass or restrictive procedures [6,7]. In an attempt to simplify the technique, but maintain the principles of BPD, we introduced in 2007 the single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) technique [8,9], which is basically a 1-anastomosis DS (Fig. 1).…”