IBC Oxford Oral Abstract 52 - Laparoscopic conversion of single anastomosis sleeve ileal (SASI) bypass to Roux-en-Y gastric bypass (RYGB) and Hiatus Hernia Repair

Abstract Background Laparoscopic conversion of Single Anastomosis Sleeve Ileal (SASI) bypass to Roux-en-Y Gastric Bypass (RYGB) and Hiatus Hernia Repair video session. Background The Single Anastomosis Sleeve Ileal (SASI) bypass is an emerging bariatric procedure, but some patients may require conversion due to complications like malnutrition, bile reflux, or inadequate weight loss. Roux-en-Y Gastric Bypass (RYGB) remains a gold standard revisional option. Objective This video demonstrates the technical steps and key considerations in converting SASI to RYGB, highlighting strategies to manage anatomical challenges and optimize outcomes. We present a laparoscopic approach for SASI-to-RYGB conversion, detailing critical steps: adhesiolysis, hiatal hernia repair, pouch creation, jejunojejunostomy, and restoration of intestinal continuity. Emphasis is placed on preserving bowel length and ensuring proper limb measurements. Results The video illustrates a successful conversion in a patient with refractory bile reflux, GERD and severe protein and vitamin deficiencies post-SASI. Key findings include shorter operative time due to meticulous pre-planning, minimal complications, and resolution of symptoms at follow-up. Conclusion Conversion from SASI to RYGB is feasible and effective with careful surgical technique. This video serves as a valuable educational resource for bariatric surgeons managing revisional cases.