D. Malkawi1, A. Chauhan1,2 1University Of Colorado Denver, Department Of Surgery, Aurora, CO, USA 2University Of Colorado Denver, GI, Trauma, And Endocrine Surgery, Aurora, CO, USA
Introduction:
The Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) was introduced as a bariatric procedure designed to replicate the weight loss outcomes of biliopancreatic diversion while reducing technical complexity and complication rates. Recently, both the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and the American Society for Metabolic & Bariatric Surgery (ASMBS) have endorsed SADI-S as a safe and effective procedure. However, due to the complexity of the hand-sewn anastomosis and the delicate handling of the duodenum required, this procedure is recommended for experienced bariatric surgeons operating in specialized centers.
Methods:
In this paper, we describe a hybrid surgical approach that leverages the efficiency and dexterity of robotic surgery while maintaining the precision of laparoscopic techniques.
Results:
The procedure begins laparoscopically with the creation of a sleeve gastrectomy, followed by the mobilization of the pylorus and proximal duodenum. The duodenoileal anastomosis is then completed robotically to optimize dexterity.
Conclusion:
We provide a detailed review of the surgical technique employed at our center, alongside a discussion of patient selection criteria, and comprehensive pre- and postoperative care protocols.