Abstract Introduction The single anastomosis sleeve ileal bypass (SASI) is a metabolic surgery that has recently gained renewed attention. Evolved from the Santoro technique, it employs an omega loop for single-anastomosis intestinal bipartition. SASI offers potential advantages, including access to the biliary tree and duodenum, reduced risk of nutritional deficiencies, and avoidance of excluded gastrointestinal segments. This report presents the initial outcomes of SASI at our center. Materials and methods We retrospectively analyzed data from 46 patients who underwent SASI between September 2024 and July 2025, evaluating their treatment outcomes. Results and discussion Of the 46 patients, most were female (n = 33; 71.7%) with a mean age of 39 ± 9.7 years. Mean preoperative body mass index (BMI) was 51,4 ± 6,2 kg/m2. Revisional operations accounted for 19,6% (n = 9) of procedures, predominantly in patients with prior gastric sleeve surgery (n = 8, 88,9%). Median operating time was 100 min (range 60–220). Two cases of iatrogenic organ perforation occurred intraoperatively, but without significant impact on the procedure or postoperative course. Most patients were discharged on the second postoperative day (n = 42, 91,3%). Early postoperative complications included three surgical site infections and one case of acute kidney injury requiring in hospital readmission. At 6 months postoperative (n = 15), overall mean total weight loss (% TWL) was 21,7%, while in primary cases was 25% and in revisional procedures was 13%. To date, no clinical or laboratory evidence of significant nutritional deficiencies has been observed in any case. Conclusion Our initial experience with the SASI procedure demonstrates its safety and positive short-term outcomes, consistent with existing literature. Continued long-term follow-up is crucial for understanding future challenges and optimizing bariatric results.
Coutinho et al. (2026) studied this question.