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Distal gastric bypass and SASI -alternatives to standard operations

By 16 May, 2019No Comments

The basic operations with us, as in the rest of Sweden, are the surgical procedures gastric bypass and sleeve gastrectomy. These complement each other in a good way, both in terms of advantages, disadvantages and efficiency. For the vast majority it is enough to choose between these two.

But sometimes we see special cases; one example is those with an extra high BMI (BMI above 50). Here, a “regular” gastric bypass can often be quite sufficient even in the long run -but not always. What to do then?


Alternative options to standard gastric bypass

Our surgeon team has researched the alternatives to standard gastric bypass -you will find a list of publications below. In order not to make it all too technical and complicated, one can say that the effectiveness of the surgery can be adjusted based on how long a portion of the intestine is disconnected (if the extra-long section of the bowel is disconnected, it is called a distal gastric bypass) or how long a part that remains from the mini-stomach to the large intestine-thus how many centimeters of small bowel that are exposed to the food after the procedure. The shorter this distance is, the more effective weight loss -but also the higher the risk of side effects.

A new option, at high BMI or when a gastric sleeve does not prove to work fully, is the operation SASI (single anastomosis sleeve ileal bypass). Watch our information video here on our site here for more information on SASI!

We will look at your specific situation in connection with our first visit with checklisting. If you might be eligible for any of our more “special” procedures, we’ll discuss it with you. Then we also discuss what special things you will need to consider afterwards (for example, more ambitious follow-up with blood tests, etc.).


Scientific work on surgical methods

Leifsson BG, Gislason H. Laparoscopic Roux-en-Y gastric bypass with 2-metre long biliopancreatic limb for morbid obesity: Technique and experience with the 150 first patients. Obesity Surgery 2005;15:35-42.


Nergaard BJ, Leifsson BG, Hedenbro J, Gislason. HG. Gastric bypass with long alimentary limb or long pancreato-biliary limb-Long-term results on weight loss, resolution of co-morbidities and metabolic parameters. Obes Surg 2014;24:1595-1602.


Shah K, Nergard BJ, Fagerland M. Gislason H. Limb length in gastric bypass in super-obese patients – importance of total alimentary small bowel tract. Accepted for publication in Obesity Surgery.


Shah K, Nergard BJ, Fagerland M. Gislason H. Distal gastric bypass – 2 m bilipancreatic limb construction with varying lengths of common channel. Accepted for publication in SOARD.


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