How I Do It: Robotic Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADIS)

Tat, Christine; Gobbo, Gabriel Díaz Del; Klingler, Michael; Corcelles, Ricard

doi:10.1007/s11605-020-04789-y

Cited by 10 publications

(10 citation statements)

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“…The mean total operative time in this study was 183.19 min, which is within the range of those reported previously for robotic SADI-S (145-204 min) [14][15][16][17] . An increase in surgeon's pro ciency with the increase in surgical experience was re ected in the operative time required; of note, the slope was more pronounced in the learning phase.…”

Section: Discussionsupporting

confidence: 86%

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Evaluation of the learning curve for totally robotic single-anastomosis duodenal–ileal bypass with sleeve gastrectomy by CUSUM analysis

Wang

Tingying

2021

Preprint

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Single-anastomosis duodenal–ileal bypass with sleeve gastrectomy (SADI-S) has similar efficacy and lower complication rate in the treatment of morbid obesity and obesity-associated metabolic diseases compared with the biliopancreatic diversion with a duodenal switch. The use of a robotic surgical system reduces surgical difficulties and improves surgical outcomes. The learning curve reflects the rate of skills or knowledge acquired in a certain period of time. However, the learning curve for robotic SADI-S has not been estimated.We used the cumulative sum analysis method to investigate the learning curve of totally robotic SADI-S. Textbook outcome analysis was performed to comprehensively define surgical success or failure.Multivariate analysis was performed to predict independent risk factors for complications and operative time. The moving average method was used to reflect the trends in operative time.This study showed that the learning curve for totally robotic SADI-S was 27 cases. Surgeon experience (case number and successful case number) was an independent predictor of the total operative time. A successful case number was the only independent predictor of surgical success or failure in this study (β = 0.084; P = 0.001). Except for the first assistant level, scrubbed nurse level, operative time, and proportion of abdominal drainage tube, there was no significant difference between the learning stage and mastery stage groups.The learning curve for totally robotic SADI-S was 27 cases. Surgeon experience including case number and successful case number were identified as independent predictors affecting the total operative time. A successful case number was the only independent predictor of surgical success or failure.

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Section: Discussionsupporting

confidence: 86%

“…SADI-S has been recommended by the International Federation for the Surgery of Obesity and Metabolic Disorders in the treatment of morbid obesity and obesity-related metabolic diseases [13] . However, only a few studies are present on robotic SADI-S [14][15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the learning curve for totally robotic single-anastomosis duodenal–ileal bypass with sleeve gastrectomy by CUSUM analysis

Wang

Tingying

2021

Preprint

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“…In our communications, we analyzed a propensity score matching case control series (robotic vs laparoscopic approach for SADI-S) in super-obese patients, where we indicated a longer operative time in robotic groups (191.54 vs 130.00 min, < 0.001), but comparable post-operative complications (3 vs 0 cases, p = 0.233) and shorter median post-operative stay (2 vs 3 days, p = 0.062). The median operative times for robotic approach in our experience is shorter than other anecdotal experiences: Tat et al [ 24 ] reported an average median of 204 min on 11 case experiences; Tarascó Palomares et al [ 25 ] reported a single-case experience with a total operative time of 240 min (of which 165 min were required to complete the SADIS procedure and 75 min to reduce and repair an umbilical hernia); and Vilallonga et al [ 26 ] experienced an average operative time of 145 min in 3 robotic SADI cases. Our data underlined the advantage of the robotic approach to perform these procedures in super-obese patients.…”

Section: Discussionmentioning

confidence: 57%

Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S): experience from a high-bariatric volume center

Pennestrì

Sessa

Prioli

et al. 2022

Langenbecks Arch Surg

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Purpose Biliopancreatic diversion with duodenal switch and single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) are technically demanding hypo-absorptive bariatric procedures generally indicated in super-obese patients (BMI ≥ 50 kg/m2). Data from the literature prove the procedure to be safe and effective, with promising bariatric and metabolic effects. Anyway, international societies support the creation of multicentric national and international registries to obtain more homogeneous data over the long period. We aimed to report our experience with this procedure. Methods Among 2313 patients who underwent bariatric procedures at our institution, between July 2016 and August 2021, 121 (5.2%) consenting patients were scheduled for SADI-S as primary (SADIS) or revisional procedure after sleeve gastrectomy (SADI) (respectively 87 and 34 patients). Early and late post-operative complications, operative time, post-operative stay, and follow-up data were analyzed. Results Overall, the median preoperative BMI was 52.3 (48.75–57.05) kg/m2 with a median age of 44 (39–51) years, the median operative time was 120 (100–155) min. Complications at 30th-day post-op were registered in 4 (3.3%) patients and late complications in 4 (3.3%) patients. At a median follow-up of 31 (14–39) months, the median percentage excess weight loss was 79.8 (55.15–91.45)%, and the median total weight loss was 57.0650 (43.3925–71.3475)%. Conclusion Our data, coherently with the literature, confirm that SADI-S is a safe, effective procedure with acceptable complications rate. Larger studies with longer follow-ups are necessary to draw definitive conclusions.

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“…In our knowledge, this is the largest series of robotic SADIS procedures reported (22) since publications in this field are scarce [17][18][19][20]. Vilalonga et al [19] reported three cases of robotic SADIS with mean operative time of 145 min.…”

Section: Discussionmentioning

confidence: 99%

Robotic vs laparoscopic approach for single anastomosis duodenal-ileal bypass with sleeve gastrectomy: a propensity score matching analysis

et al. 2022

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Biliopancreatic diversion with duodenal switch and single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) are technically demanding hypo-absorptive bariatric procedures. They are often indicated in superobese patients (BMI ≥ 50 kg/m2), as robotic platform could improve ergonomics against a thick abdominal wall, preventing bending of instruments and simplifying hand-sewn anastomoses. We aimed to report our experience with robotic SADI-S (R-group) and to compare outcomes with the laparoscopic (L-group) approach. Among 2143 patients who underwent bariatric procedures at our institution between July 2016 and June 2021, 116 (5.4%) consenting patients were scheduled for SADI-S as primary or revisional procedure: 94 L-group, 22 R-group. R-group and L-group patients were matched using PSM analysis to overcome patients selection bias. Postoperative complications, operative time (OT), post-operative stay (POS) and follow-up data were compared. After PSM, 44 patients (22 patients for each group) were compared (Chi-square 0.317, p = 0.985). Median age, gender, median BMI, preoperative rates of comorbidities, previous abdominal bariatric and non-bariatric surgeries and type of surgical procedures (SADI-S/SADI) were comparable. Median OT was shorter in the L-group (130 Vs 191 min, p < 0.001). 30-days’ re-operative complications and late complications rates were comparable. At 25-months’ mean follow-up, the median Percentage Excess Weight Loss (72%) was comparable between the groups (p = 0.989). L-group and R-group were comparable in terms of re-operative complication rate and short-term outcomes. The robotic platform may increase the rate of single step procedure in challenging cases. Larger studies with longer follow-up and cost-analysis are necessary to draw definitive conclusions.

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How I Do It: Robotic Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADIS)

Cited by 10 publications

References 1 publication

Evaluation of the learning curve for totally robotic single-anastomosis duodenal–ileal bypass with sleeve gastrectomy by CUSUM analysis

Evaluation of the learning curve for totally robotic single-anastomosis duodenal–ileal bypass with sleeve gastrectomy by CUSUM analysis

Single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S): experience from a high-bariatric volume center

Robotic vs laparoscopic approach for single anastomosis duodenal-ileal bypass with sleeve gastrectomy: a propensity score matching analysis

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