Here the sleeve gastrectomy operation is added with a "duodenal-jejunal bypass" either with a single anastamosis (SADJB) or a double anastamosis. There is total cut-off of food passage into the duodenum and the upper small intestine, in both techniques. The stomach tube (sleeve) along with the upper divided part of the duodenum is connected to the intestine about 2 metes below its origin.
In this, the sleeve gastrectomy operation is added with a "single anastamosis duodenal-ileal bypass" (SADI). Here too, there is total cut-off of food passage into the duodenum and the jejunum. The stomach tube (sleeve) along with the upper divided part of the duodenum is connected to the intestine much lower (ileum). Because a large portion of the intestine is bypassed in this operation, there are high incidences of nutritional deficiencies. However the remission of diabetes is better.
Here, the sleeve gastrectomy is added with a channel that goes from the stomach tube to the lower small intestine (ileum). However, as the duodenum is kept connected, part of the food goes via the duodenum normally down while the other part of it into the new channel straight to the ileum (sleeve bipartition). This is reported to have lesser nutritional deficiencies, yet very effective to treat diabetes. This is also known as Santoro's operation after its inventor.
This procedure is similar to Santoro's operation. However, here the sleeve is connected with a single connection to a loop of ileum. It is hence known as single anastamosis sleeve ileal (SASI) bypass. The principle is same as that of the bipartition and hence reportedly gives similar results.
In addition to the sleeve gastrectomy, this operation uses a transected segment of ileum to be shifted and interposed, closer to the duodenum. There are 2 variations of this operation - with and without duodenal switch (transection of duodenum with interposition). However, it involves greater number of transections and re-connections than any other bariatric procedure.
The proponents of this operation also tailor the amount of stomach resected depending on the body weight. This operation is mainly used to address non-obese diabetic patients.
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