Laparoscopic Single Anastomosis Sleeve-Jejunal (SASJ) Bypass

Background: Bariatric and metabolic operations have gained distinctive and worldwide approval given the confirmedefficiency and safety of bariatric approaches and the increasing prevalence of obesity and its accompanying co-morbidities.A novel procedure was developed to form an anastomosis between the sleeve gastrectomy (SG) and the jejunum insteadof the ileum (SASJ).Patients and Methods: This prospective study enrolled 30 cases diagnosed with morbid obesity and scheduled forlaparoscopic SASJ. All patients received standard preoperative preparation including history taking, clinical examination,laboratory investigations, pelviabdominal ultrasound, and upper gastrointestinal (UGI) endoscopy. The operationwas conducted for all of them, and they were followed for one year after the procedure. We recorded postoperativecomplications, the %EWL, and changes in obesity-related comorbidities.Results: The mean values of %EWL were 21.39, 40.44, 54.46, and 71.86% at one-, three-, six-, and twelve-monthfollow-up visits respectively. Late postoperative complications included dumping syndrome (6.67%), hair loss (10%), andhypocalcemia (6.67%), while no patients developed sleeve tube stenosis during the follow-up period. The SASJ procedurewas accompanied by excellent diabetic outcomes. All patients with pre-existing dyslipidaemia showed remission orimprovement after twelve months. All patients with pre-existing OSAS showed improvement in their condition, and thatimprovement persisted till the twelve-month follow-up visit. There was a significant improvement in the quality of life(QoL) after the procedure as manifested by the increased QOLOS 1 questionnaire values after the procedure comparedto the preoperative one. Also, QOLOS 2 questionnaire also showed significantly increased values after the procedure.Conclusion: SASJ is a safe and efficacious bariatric approach, as it yields excellent weight loss (WL) outcomes,improvement of obesity-related comorbidities, with low risk of postsurgical complications.