Reversal to Normal Anatomy for Patients With Excessive Weight Loss or Severe Malnutrition After Single Anastomosis Sleeve Ileal (SASI) Bypass.

BACKGROUND

Metabolic and bariatric surgery (MBS) has been an effective solution not only to obesity but also to metabolic diseases. As the demand for revisional surgery increases with the expansion of MBS, possible risks and complications of reoperation should be considered.

METHOD: We have collected and analyzed 3 patients diagnosed with class III obesity who underwent the single anastomosis sleeve ileal bypass (SASI) as a primary operation. Due to excessive weight loss or severe malnutrition, they were indicated for revisional surgery, where SASI was reversed to sleeve gastrectomy (SG) ( Fig. 1 ). The perioperative characteristics as well as outcomes after SASI and revisional surgery are reviewed.

RESULTS

The confirmed measurement of their common channels in 3 patients with SASI revealed 350, 250, and 250 cm, respectively. The mean operative time was 42.3 minutes and blood loss was <20 mL. There were no intraoperative or postoperative complications. The patients had uneventful postoperative courses and the mean hospital stay was 2.3 days. There was no mortality in our cases. Malabsorption with nutrition issues was improved in each patient.

CONCLUSION

Laparoscopic revision of SASI to SG is a technically feasible and practical procedure for patients with excessive weight loss or malnutrition.