SASI-S

Service Description

SASI-S (Single Anastomosis Stomach–Ileal Bypass with Sleeve) is a new-generation, hybrid bariatric procedure that combines Vertical Sleeve Gastrectomy (VSG) with a single anastomosis between the stomach and distal ileum. It's designed to offer the benefits of both restrictive and malabsorptive surgeries, while aiming to preserve physiological function and reduce long-term complications. 🧠 What is SASI-S (Single Anastomosis Stomach-Ileal + Sleeve)? SASI-S combines two mechanisms: - Sleeve Gastrectomy: Restricts stomach volume and reduces ghrelin (hunger hormone). - Stomach-to-Ileum Bypass: Creates a loop bypass from the stomach (post-pyloric) to the distal ileum (~250 cm from the ileocecal valve), which allows partial malabsorption and a metabolic effect via early exposure of undigested nutrients to the ileum. 📊 How it Works (Anatomy in Brief) Food can take two routes: - The natural digestive pathway through the duodenum and jejunum. - A shortcut to the ileum through the gastroileal anastomosis. This dual pathway allows the body to maintain some physiological digestion while still achieving powerful metabolic effects. ⚠️ Considerations and Risks - Bile reflux may still occur (due to loop configuration) - Long-term data is still limited, as it's a newer procedure - Nutrient deficiencies are possible and require monitoring - Less known among bariatric teams, so surgeon experience matters Ideal Candidates - BMI ≥35 with metabolic disease - Patients seeking less malabsorption than SADI-S or RYGB, but more metabolic effect than sleeve alone - Good option for revisional surgery after failed VSG Summary SASI-S is an evolving, promising procedure offering a balanced mix of restriction and malabsorption. It avoids intestinal rerouting complexity while still improving metabolic markers. While long-term data is still maturing, it shows great potential—especially in experienced hands or as part of a stepwise surgical approach.