Yi-Chen Ho

Taipei Mackay Memorial Hospital, Taiwan

Abstract Title:Case Discussion on Singl Anastomosis Sleeve-Ileal Bypass (SASI) at MacKay Memorial Hospital and Its Effects on Gastroesophageal Reflux Disease and Diabetes

Biography:

Main academic qualifications: Department of Medicine, Mackay Medical College, Taiwan Main experience: Department of Surgery Fellow, Mackay Memorial Hospital, Taiwan

Research Interest:

Single Anastomosis Sleeve-Ileal Bypass (SASI) is a bariatric and metabolic procedure that combines sleeve gastrectomy (SG) with an ileal bypass. It promotes weight loss and metabolic improvement by restricting food intake and altering the intestinal nutrient absorption pathway. Numerous studies have demonstrated its particular effectiveness in patients with obesity and type 2 diabetes mellitus (T2DM). SASI contributes to diabetes control through multiple mechanisms, including enhancing gut hormone secretion such as glucagon-like peptide-1 (GLP-1) and peptide YY (PYY), which improves insulin sensitivity, as well as reducing insulin resistance, leading to better glucose metabolism and more stable blood glucose levels. In addition, decreased nutrient absorption and resulting weight loss further enhance the likelihood of diabetes remission. The impact of SASI on gastroesophageal reflux disease (GERD) varies among individuals. While sleeve gastrectomy may increase intragastric pressure and potentially worsen GERD symptoms in some cases, the intestinal bypass component of SASI may shorten gastric emptying time and reduce acid reflux, thus improving symptoms in others. Consequently, the effect of SASI on GERD requires further study and should be evaluated on a case-by-case basis. In our hospital, SASI was performed for 30 patients from 2024/07 to 2025/04. In this present, we discuss the change of total weight loss, excess weight loss, BMI change and the result of T2DM and GERD remission rate. We also share cases of revision laparoscopic SG to SASI due to hiatal hernia and persistent GERD. Overall, SASI has demonstrated promising outcomes in terms of diabetes management and weight reduction. Compared with the traditional Roux-en-Y gastric bypass (RYGB), SASI is technically simpler and associated with fewer nutritional deficiencies. However, careful postoperative monitoring of GERD symptoms and long-term nutritional status remains essential to ensure sustained surgical efficacy and patient health.
Keywords: Single Anastomosis Sleeve-Ileal Bypass (SASI), Gastroesophageal Reflux Disease (GERD), Type 2 Diabetes Mellitus (T2DM), Bariatric Surgery, Metabolic Surgery.