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From Our One Anastomosis Gastric Bypass (OAGB) Experience to Establishing Single Anastomosis Sleeve Ileal (SASI) Bypass Procedure: A Single-Center Report

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Abstract

Background

Bariatric surgery has been proven to be the most effective treatment for obesity with or without metabolic syndrome. One anastomosis gastric bypass (OAGB) is a well-established bariatric procedure developed over the past 20 years with excellent outcomes. Single anastomosis sleeve ileal (SASI) bypass is introduced as a novel bariatric and metabolic procedure. There is some similarity between these two operations. This study aimed to present our SASI procedure based on the past experience of the OAGB in our center.

Method

Thirty patients with obesity underwent SASI surgery from March 2021 to June 2022. Herein, we demonstrated our techniques step by step and key points of techniques learned from our experience with OAGB (shown in the video) with satisfying surgical outcomes. The clinical characteristics, peri-operative variables, and short-term outcomes were reviewed.

Results

There was no case of conversion to open surgery. The mean operative time, volume of blood loss, and hospital stay were 135.2 ± 39.2 min, 16.5 ± 6.2 mL, and 3.6 ± 0.8 days, respectively. There is no postoperative leakage, bleeding, or mortality. The percentage of total weight loss and excess weight loss at 6 months were 31.2 ± 6.5 and 75.3 ± 14.9, respectively. Improvement in type 2 diabetes (11/11, 100%), hypertension (14/26, 53.8%), dyslipidemia (16/21, 76.2%), and obstructive sleep apnea (9/11, 81.8%) were observed at 6 months after surgery.

Conclusion

Our experience showed that our proposed SASI technique is feasible and may help surgeons perform this promising bariatric procedure without encountering many obstacles.

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Acknowledgements

We thank Veronica, Yu-Yi Chang for her assistance in recording the video narration.

Author information

Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Cheng-Kung Road, Neihu District, Taipei, 114202, Taiwan

    Kuo-Feng Hsu, Shu-Wei Chang, Hsin-Mei Pan, Wan-Ting Hung, Chien-Hua Lin & Guo-Shiou Liao

  2. Medical Weight Loss Center, China Medical University Hsinchu Hospital, Hsinchu, Taiwan

    Wei-Jei Lee

  3. Bariatric and Metabolic Surgery Center, Ten-Chan General Hospital, Taoyuan, Taiwan

    Kong-Han Ser

  4. Research Assistant Center, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan

    Yen-Ju Chen

  5. Division of General Surgery, Department of Surgery, Taichung Armed Forces General Hospital, Taichung, Taiwan

    Wan-Ting Hung

  6. IRCAD Taiwan, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan

    Chien-Hua Lin

  7. Metabolic & Bariatric Surgical Department, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 66, Sec. 1, Fengxing Road, Tanzi District, Taichung, 427213, Taiwan

    Ming-Hsien Lee

  8. Department of Surgery, School of Medicine, Tzu Chi University, Hualien, Taiwan

    Ming-Hsien Lee

  9. Center for Weight Loss and Health Management, E-DA Dachang Hospital, No. 305, Dachang 1st Road, Sanmin District, Kaohsiung, 807066, Taiwan

    Tien-Chou Soong

  10. College of Medicine, I-Shou University, Kaohsiung, Taiwan

    Tien-Chou Soong

Authors
  1. Kuo-Feng Hsu
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  2. Shu-Wei Chang
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  3. Wei-Jei Lee
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  4. Kong-Han Ser
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  6. Yen-Ju Chen
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  7. Wan-Ting Hung
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  8. Chien-Hua Lin
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  9. Guo-Shiou Liao
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  10. Ming-Hsien Lee
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  11. Tien-Chou Soong
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Corresponding authors

Correspondence to Kuo-Feng Hsu, Ming-Hsien Lee or Tien-Chou Soong.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare no competing interests.

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Key Points

1. Laparoscopic single anastomosis sleeve ileal (SASI) bypass surgery is an emerging innovative bariatric procedure with satisfying outcomes in weight loss and improvement of metabolic diseases.

2. One anastomosis gastric bypass (OAGB) has its development history and has been endorsed as a valid bariatric operation by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and the American Society for Metabolic and Bariatric Surgery (ASMBS) successively.

3. We apply the past experiences in surgical techniques and aspects of OAGB to establish our SASI procedure and herein present the surgical outcomes.

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Hsu, KF., Chang, SW., Lee, WJ. et al. From Our One Anastomosis Gastric Bypass (OAGB) Experience to Establishing Single Anastomosis Sleeve Ileal (SASI) Bypass Procedure: A Single-Center Report. OBES SURG 33, 1318–1322 (2023). https://doi.org/10.1007/s11695-023-06523-4

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  • DOI: https://doi.org/10.1007/s11695-023-06523-4

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