SASI-S (Single Anastomosis Stomach–Ileal Bypass with Sleeve Gastrectomy) is a modified and safer version of SADI-S (Single Anastomosis Duodenal–Ileal Bypass with Sleeve Gastrectomy). SASI-S combines the benefits of sleeve gastrectomy and intestinal bypass.
Sleeve gastrectomy removes 75% of the stomach resulting in a reduced capacity to eat and a reduced level of ghrelin, the hormone which causes hunger. Intestinal bypass involves joining the bottom part of the stomach (antrum) to the lower part of the small bowel (ileum).
This results in food bypassing part of the small intestine which causes a reduction in the absorption of fats, sugar and calories that are consumed. The amount of small bowel bypassed can be varied depending on the desired weight loss.
Advantages of the SASI-S procedure
Studies show SASI-S can provide greater weight loss than either a standard sleeve gastrectomy or gastric bypass. Some other advantages of SASI-S include:
- Combines benefits of sleeve and bypass
- Less risk of a leak from staple line as there are fewer staple lines than SADI-S
- Less risk of staple line leak from the sleeve as the muscle at the outlet of the stomach (pylorus) is bypassed
- Less risk of nutritional deficiencies as duodenum not excluded
- Access to bile duct to remove gallstones is intact (ERCP possible)
- Less risk of internal hernia
Disadvantages of the SASI-S procedure
- Increased risk of bile reflux into the stomach
- Weight loss may be less than SADI-S
How does Dr Kevin Dolan perform the SASI-S procedure?
The SASI-S procedure is a two-step process:
- Create sleeve gastrectomy.
- Join the bottom part of the stomach (antrum) to the distal part of the small bowel (ileum). The length of the bypass can be varied depending on the desired weight loss.
Following your surgery, you will spend two days in the hospital and will be administered pain-controlling medications to keep you comfortable. For the first two weeks following your surgery, you will be kept on a liquid diet. Your surgeon and dietician will give you a specific diet plan and instructions to follow after this. It is important to drink plenty of fluids throughout the day to avoid dehydration.
What are the Costs and Funding Options for SASI-S Surgery?
Costs will vary from $0 to $6000 out of pocket expenses depending on the complexity of the surgery and the previous surgery weight. Dr Dolan will discuss costs at your first consultation.
Medicare rebates are available for this procedure and our surgery offers payment plans for patients.
For more costs and information, visit our Costs page.
Single Anastomosis Stomach–Ileal Bypass with Sleeve Gastrectomy FAQs
Single Anastomosis Stomach–Ileal Bypass with Sleeve Gastrectomy, or SASI-S as it is commonly known, is a modified and safer version of SADI-S. SASI-S combines the benefits of both intestinal bypass and sleeve gastrectomy to effectively treat morbid obesity. During the procedure, a large portion of the stomach is removed in order to reduce one’s capacity to eat and to reduce one’s level of ghrelin (the hunger hormone), while the bottom part of the stomach (antrum) is joined to the distal small bowel (ileum) so that food bypasses part of the small intestine. This works by reducing the number of fats, sugar and calories that are absorbed by the body.
According to studies, the SASI-S procedure is able to provide greater weight loss than either a standard sleeve gastrectomy or gastric bypass procedure. SASI-S is safer than SADI-S due to fewer staple lines and only one join, so less risk of an internal hernia. SASI-S has fewer nutritional deficiencies such as iron as the duodenum is not excluded. Endoscopy to check on the stomach and duodenum is possible after SASI-S, the only bypass to allow this.
The SASI-S procedure may increase the risk of bile reflux into the stomach. Dr Dolan will advise you as to whether SASI-S is the best option for you, depending on your particular circumstances and health condition. He will also let you know about any other options available to you.