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Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a new operation for morbid obesity based on the biliopancreatic diversion in which a sleeve gastrectomy is followed by an end-to-side duodeno-ileal diversion. The preservation of the pylorus makes possible the reconstruction in one loop, which reduces operating time and needs no mesentery opening. 1

SADI-S is a promising operation which offers excellent weight loss and metabolic results. The elimination of one anastomosis reduces operative time and decreases the possibility of surgically related complications. 2

The Roux-En-Y Gastric Bypass, is considered the "gold standard" of modern obesity surgery
It is a restrictive procedure combined with a modified gastric bypass that moderately limits calorie and nutrient absorption and may lead to altered food choices. The Roux-En-Y works by decreasing food intake, limiting the amount of food the stomach can hold by closing off a significant portion of the stomach and delaying the emptying of the stomach (gastric pouch).
This procedure is a combination of restriction and malabsorption and therefore has a two-way weight reducing effect.*


Laparoscopic sleeve gastrectomy was initially proposed as a first-stage procedure to perform in higher-risk patients in order to achieve significant weight loss prior to more complex bariatric procedures in a second stage. Laparoscopic Sleeve Gastrectomy Procedure description
Within the laparoscopic Sleeve Gastrectomy approximately 75% of the stomach will be removed to leave a narrow gastric tube which restricts food intake.

Many surgeons reported an acceptable complication rate and significant weight loss following Sleeve Gastrectomy in higher-risk patients. Soon it was noted that patients frequently lost so much weight that they did not require a second stage. These positive results encouraged surgeons to perform Sleeve Gastrectomy more frequently.*


The sleeve gastrectomy (SG) is currently one of the most frequently performed bariatric procedures worldwide but there is a growing concern about its connection to gastroesophageal reflux. In general, it is estimated that 10% to 20% of patients suffer from symptomatic reflux after an SG, regardless of whether or not they used to have it before surgery (1) .
The Nissen Sleeve Gastrectomy is a surgical technique consists on creating a short and narrow Nissen valve around the sleeved stomach. Good results have been shown after a year of follow up.
Study results showing that the Nissen sleeve could be a great choice among bariatric techniques even to prevent the new onset of GERD in sleeve patients.*


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