Intestinal Bipartition After Failed Sleeve Gastrectomy: a Safe and Simple Alternative Technique in a Challenging Case with Vascular Anomalies

Obes Surg. 2022 May;32(5):1788-1790. doi: 10.1007/s11695-022-06004-0. Epub 2022 Mar 19.

Abstract

Sleeve gastrectomy (SG) is the most performed bariatric surgery worldwide but approximately 50% of patients will present insufficient weight loss or weight regain after surgery. In 2004, Santoro et al. described an alternative revisional technique other than DS and RYGBP called intestinal bipartition (IB). It involves a pre-pyloric gastro-ileal and an ileo-ileal anastomosis without exclusion of intestinal segments. Duodenal dissection is not necessary, making it an easier and more reproducible technical alternative to DS. its preliminary reports show good weight control with resolution of obesity related comorbidities. We present our technical suggestions to perform a safe IB in a patient with a failed SG in whom revisional DS or RYGBP were not feasible due to a vascular anomaly.

Keywords: Intestinal bipartition; Revisional surgery; Vascular anomaly; Weight regain.

MeSH terms

  • Gastrectomy
  • Gastric Bypass*
  • Humans
  • Laparoscopy*
  • Obesity, Morbid* / surgery
  • Reoperation / methods
  • Retrospective Studies
  • Weight Loss