Single anastomosis sleeve ileal (SASI) bypass as a primary and revisional procedure: a single-centre experience

Introduction
To achieve effective weight loss and remission of comorbidities, various surgical methods are used in the treatment of obesity. The most common procedures performed worldwide are followed by the newest ones. Aim: To present the results of the first group of patients from a high-volume bariatric centre in central Europe and to compare single anastomosis sleeve ileal (SASI) as a primary and revisional procedure.

Material and methods
We retrospectively analysed patients who underwent SASI for obesity from December 2018 to June 2022 by the same team of surgeons. There were 2 groups of patients. The first group consisted of patients who underwent SASI as their first bariatric procedure (primary group – PG). The second group consisted of patients who underwent SASI after previous SG procedure due to weight regain and/or symptoms of gastroesophageal reflux disease (GERD) (revisional group – RG).

Results
There were 15 patients (80% female) in the PG, and 14 patients (88% female) in the RG. In the PG, %TWL 12 and 36 months after surgery was 37.8% and 43.9% respectively. In the RG, %TWL 12 and 24 months after surgery was 13.8% and 20.9%, respectively. Most patients had complete remission of T2D and HT after surgery. In the RG, 9 (81.8%) patients had remission of GERD. The worsening of GERD was reported in 4 (40%) patints in the PG.

Conclusions
SASI may be an effective and safe method of treatment of obesity. SASI may be an effective method of revisional bariatric surgery performed for GERD, but not for weight regain.