SADI-S surgery

SADI-S surgery
Режущие линии
Специальность	гастроэнтерология

Result

SADI-S (одноразовый двенадцатипер-либельный шунтирование с общедоступной гастроэктомией в рукаве )-это бариатрическая хирургическая техника для устранения метаболических нарушений и похудения. Это вариация операции на переключателе двенадцатиперстной кишки , включающая гастрэктомию с вертикальной рукавом с помощью метода желудочного обхода .

SADI-S-это тип бариатрической хирургии с одним хирургическим анастомозом . У него есть ограничительный компонент при уменьшении большей кривизны желудка, но особенно малабсорптивного компонента, поскольку общий канал также уменьшается. Целью этой хирургической техники является уменьшение кишечной петли, где поглощаются питательные вещества.

Техника

Это может быть выполнено лапаротомией или лапароскопией . Небольшой желудочный рукав создается путем разделения большей кривизны желудка, например, в технике рукава. Впоследствии двенадцатиперстная кишка пересекается в отношении пилора. Анастомоз двенадцатиперстной кишки проводится между 250 сантиметрами (98 дюймов) до 300 сантиметров (120 дюймов) из илеоцекального клапана. Следовательно, это расстояние становится длиной общего канала, где поглощаются питательные вещества.

Advantages

The SADI-S is a single anastomosis bariatric surgery. It is different from the classic duodenal switch, the gastric bypass (RNY) or sleeve gastrectomy. It is a type of bariatric surgery carried out to lose weight and to mitigate various metabolic issues including Type 2 Diabetes, dislipidemia, Metabolic Syndrome, and Polycystic Ovarian Syndrome.

In published studies, total weight loss and the positive impact or remission of Type 2 Diabetes was better with the SADI-S surgery than with gastric bypass or sleeve gastrectomy.

When compared to RNY surgery, the SADI preserves the stomach/pyloric valve, thus maintaining more anatomical control over release of food into the intestines, and reducing the risk or frequency of dumping syndrome.

When compared to the Duodenal Switch (DS), in addition to requiring only a single anastomosis (which reduces the incidence of leakage or stricture complication ), the SADI surgery typically leaves a longer common channel than the DS. This reduces the severity of malnutrition tied to malabsorption, and mitigates the degree of diarrhea and flatulence associated with DS.

Disadvantages

As with other bariatric malabsorptive techniques, including RNY and DS, patients will need to take vitamin supplements A, D, E, K and minerals throughout their lives. Analytical monitoring is necessary to prevent malnutrition.

Stones in the gallbladder, flatulence and diarrhea are more frequent than with the non-bariatric population.

The surgical risks are similar as in other bariatric techniques, including intestinal perforation, infection, abscess, venous thrombosis, pulmonary embolism, and andanastomotic leaks (although the single anastomosis is designed to present less risk overall compared to the multi-anastomosis techniques). In the long term, it can produce a bowel obstruction. There is a greater chance of bile reflux than a traditional duodenal switch.

While previously considered experimental, in 2020 and 2018, respectively, both the American Society of Metabolic and Bariatric Surgery (ASMBS) and The International Federation for Surgery of Obesity and Metabolic Disorders (IFSO) released statements endorsing SADI as an effective and established surgical technique. While there is no research to indicate that it has any significant reduction in vitamin or mineral supplementation as compared to the Roux-en-Y gastric bypass surgical technique, the typically longer common channel in SADI, compared to Duodenal Switch surgery, means there is a somewhat lower degree of nutritional deficiency.

See also

• SIPS surgery

Bibliography

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External links

• Media related to SADI-S surgery at Wikimedia Commons
• Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up.