Laparoscopic Single Anastomosis Sleeve Ileal (SASI) Bypass for Patients With Morbid Obesity: Technical Description and Short-term Outcomes

Background: Morbid obesity has been recognized as a public health crisis, particularly in developed countries. Single anastomosis sleeve ileal (SASI) bypass has been introduced as a novel bariatric and metabolic procedure. The present study aimed to describe the technical steps and assess the short-term outcomes of SASI bypass in patients with super morbid obesity. Patients and Methods: Adult patients of both sexes with body mass index (BMI) >= 50 kg/m(2) underwent SASI bypass and were followed for 12 months postoperatively. Changes in BMI, excess weight loss (EWL), and improvement in comorbidities were recorded on follow-up. Results: Twenty patients (17 female) of the mean age of 35.4 years were included in the study. The mean preoperative BMI (53.7 +/- 5.9) showed a significant decrease at 6 months (39.9 +/- 5.2) and then at 12 months (33.6 +/- 6) postoperatively. The mean %EWL was 44.3 +/- 7.8 at 6 months and 65.2 +/- 12.6 at 12 months. All patients with diabetes mellitus, osteoarthritis, and reflux esophagitis showed resolution at 12 months after the SASI bypass. Complications were recorded in 2 patients and no mortality was reported. Conclusions: SASI bypass is an effective and safe bariatric procedure that confers significant loss of weight and improvement in medical comorbidities. As compared with previous studies on patients with lower BMI, patients with super morbid obesity attained lower %EWL but similar resolution of diabetes mellitus at 12 months after SASI bypass.