Andrés Sánchez-Pernaute (SPAIN) and his team at Hospital Clínico San Carlos, Madrid, Spain, perform a SADI-S procedure.
Case Record:
Clinical Background
Female, 45 y.o.
115 kg
153 cm
49 kg/m2
Technique Description
Clinical History:
Lap chole
Obstructive apnoea
No gerd, no hiatal hernia
Technique Description:
Sleeve gastrectomy over a 54 french bougie. Duodenal section and anastomosis to the ileum 250 cm from the ileo-cecal junction.
Procedures Steps:
Division of short gastric vessels and branches of the right gastroepiploic artery
Dissection of the duodenum down to the bile duct
Gastric sleeve resection over a wide bougie
Division of the duodenum
Measurement of the small bowel from the ileocecal junction upwards
Duodeno-ileal end-to-side anastomosis
Learning Points:
Complete fundus dissection to warrant a correct sleeve gastrectomy – use wide bougie, avoid strictures
Long duodenal dissection with preservation of pyloric vascularization and innervation
Distal to proximal measurement of the small bowel to know the exact length of the common limb
Take your time to perform a safe anastomosis
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