Following an initial sleeve gastrectomy, an increasing number of patients will have weight regain or inadequate weight loss. While many alternatives have been discussed, the most effective approach is to add an adequate length intestinal bypass. Repeating a restrictive procedure is unlikely to lead to lasting weight loss. To determine the optimal procedure, an endoscopy is required. For patients without Barretts or severe esophagitis, Sadi or SIPPs is an excellent alternative. In this video we demonstrate the conversion of sleeve to SADI-A in a patient who initially had a bmi of 60. Following sleeve she had a nadir BMI of 42 and BMI was up to 47 at time of revision. The original sleeve was done in 2018. She was only on vitamin supplements pre-operatively.
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