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SIPS (SADI-S) Bariatric Surgery

 

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SIPS which is also known as SADI -S (Single anastomosis Duodeno- ileal Bypass with Sleeve gastrectomy) is an effective weight loss procedure. Certainly, the weight loss results are encouraging. Analyses of results suggest that on average, patients will lose over 12-19 BMI units, 1 year from surgery. SIPS (SADI -S) combines a vertical sleeve that is slightly larger than standard VSG, with an intestinal shortening procedure. By shortening the intestinal length, combined with the resection of the fundus and greater curvature, food consumed reaches the distal intestine more rapidly. This stimulates the cells in this region to release incretins that alter hunger and satiety. The preservation of 3 m of the intestine along with the ileocecal valve may reduce the risk of malnutrition and diarrhoea.
Unlike the roux en y gastric bypass the pylorus is preserved in this operation. The pylorus provides control of solid emptying, reducing the chances of dumping syndrome and assisting in maintaining a physiologically based rate of gastric emptying. Thus, with SIPS (SADI -S), our hope is that we can provide an efficacious procedure that offers improved quality of life, adequate intake and rely on the passage of ingested food into the faecal stream.

Who might prefer this procedure?

Those who not only want to feel full earlier, as with the procedures, but quieten their food
cravings as well, thanks to the hormonal changes triggered by the surgery
Calorie counters: The procedure modifies the digestive system so it won’t process as many calories as before

Length of stay

RNY, SIPS (SADI -S) and other gastric bypass patients only need to stay 1-2 nights in hospital.
Most patients recover fully in 2 to 4 weeks.

Benefits

  • Less protein energy malnutrition and vitamin deficiencies
  • Facilitates absorption of iron, calcium and vitamin B12
  • Beneficial effect on diabetes
  • Ability to eat normally like with the sleeve
  • No dumping syndrome as pylorus is preserved
  • No increased risk of anastomotic ulcers
  • No increased risk of internal hernias
  • Excellent technique for failed sleeves as it avoids anastomosis in area of adhesions and induration from prior surgery
  • Avoids the controversy of gastric cancer in the gastric remnant due to bile reflux as in Omega loop or Mini Gastric bypass

Risks of SIPS

  • Data beyond 5 years or longer term is not available
  • SIPS  (SADI -S) cannot be reversed
  • Increase in number of bowel movements to average 2.5 times
  • Cardiovascular problems (especially with unidentified pre-existing heart disease): Heart attack, stroke or death
  • Respiratory problems: Pneumonia, pulmonary embolus
  • Wound problems: Wound infection (<5%), hernia development (1% for laparoscopic)
  • Circulation: Problems include blood clots in legs and blood clots migrating to lungs
  • Death Can Occur: For Laparoscopic Gastric Bypass (0.5 – 1%)

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