Single-anastomosis duodeno-ileal - new revision procedure in a patient with insufficient weight loss after sleeve gastrectomy.

Abstract

Laparoscopic sleeve gastrectomy (LSG) is one of the most popular and effective bariatric surgical procedures worldwide. The effect of LSG is mostly dependent on the restrictive mechanism, which makes it more vulnerable to failure. Failing of bariatric procedure is not uncommon and occurs in 6% to 23%. In case of weight loss failure, there are no hard recommendations on the choice of the redo procedure. One of the most novel options, introduced in 2007, relatively simple to perform following LSG is single-anastomosis duodenoileal bypass. Herein we describe surgical technique and history of a patient with inadequate weight loss after laparoscopic sleeve gastrectomy, who underwent single-anastomosis duodenoileal bypass.

First Case Report of Acquired Copper Deficiency Following Revisional Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) Leading to Severe Pancytopenia with Refractory Anemia

“…The patient underwent LSG as a primary weight loss surgery followed by SADI-S as revisional surgery. Weight loss surgery that is characterized by combined restrictive and malabsorptive effects alters copper absorption in the stomach, duodenum, and ilium [13]. In addition, other factors e.g.…”

Single-Anastomosis Procedures in Metabolic Surgery

“…7 Several authors have utilized SADI-S as a revision surgery for suboptimal weight loss or weight regain following sleeve gastrectomy (SG) or as a primary weight loss surgery. 8,9 Description of the Surgical Technique SADI-S is traditionally performed laparoscopically and more recently has been reported to be safely done robotically. 10,11 During the procedure, a sleeve-like gastric pouch is created followed by division of the duodenum past the pylorus.…”