ThP3.10 - Initial experience with laparoscopic single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) in Class IV (BMI 50-60kg/m2) and Class V (BMI > 60 kg/m2) Obesity

Abstract Aims Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a simplification of the duodenal switch (DS) in which alimentary limb is eliminated, and common channel is lengthened from 200 to 300 cm is gaining recognition as effective procedure in Class IV (BMI 50-60 kg/m2) and Class V (BMI >60 kg/m2) obesity. The aim of study is to discuss the surgical technique and analyse initial outcomes after introduction of SADI-S in our department for management of Class IV and Class V Obesity. Methods This is a retrospective cohort study of consecutive patients who underwent SADI-S at a tertiary level teaching hospital in NHS. Only patients who underwent single stage SADI-S procedure with minimal follow-up of 30 days were included in study. Patients who underwent Sleeve gastrectomy first, followed by duodenal switch in second stage as part of two-stage strategy were excluded. Results Total 14 patients, 2 (14.2%) males and 12 (85.8%) females were included in study. The median pre-op BMI was 56.1 (51.95-69) kg/M2 and median Pre-op weight was 149.2 (121.8 – 163.2) kg. 9 pts had diabetes, 11 pts OSA on CPAP, 8 pts HTN, 6 pts fibromyalgia etc. 1 patient had sleeve staple-line bleed which was managed conservatively with fluids and blood transfusion. No re-operations, mortality or re-admissions were recorded. Median length of stay was 2 days. Conclusion SADI-S is a promising surgery in Class IV and Class V obesity patients with low postoperative morbidity. The postoperative recovery and protocol is similar to standard procedure like sleeve gastrectomy and Roux-Y-gastric bypass.