The single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) has become one of the most important emerging bariatric surgery procedures. Accepted as a procedure by both IFSO and ASMBS, its short and medium-term results have led it to be considered an excellent option both as a single procedure and in in revisional surgery, especially in cases of weight regain or insufficient weight loss after vertical gastrectomy.
In this lecture, Dr. Balibrea reviews the principles and pathophysiological basis of the procedure, its indications, as well as the main technical aspects. Due to its hypoabsorptive component, this technique provides excellent results both in weight loss and in the control of comorbidities. However, due to the potential nutritional complications, one of the most important factors is patient selection.
In this lecture, each phase of the procedure is reviewed step by step: positioning of the patient and trocars, sleeve gastrectomy, antral dissection, identification of anatomical landmarks (gastroduodenal and right gastric arteries), duodenal dissection and transection, identification of the ileo-cecal valve, and measurement of the common channel, as well as manual duodeno-ileal anastomosis. In each of the steps, recommendations are given for optimal execution as well as for avoiding and solving and potential problems that may arise during surgery.
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