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Single-Anastomosis Plication Ileal Bypass (SAPI) in Treatment of Morbid Obesity

Elbanna, Hosam, MD; Emile, Sameh, MD; Abdel-Razik, Mohamed A., MD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: April 2019 - Volume 29 - Issue 2 - p e12–e14
doi: 10.1097/SLE.0000000000000600
Online Articles: Technical Reports

Background: This report aimed to demonstrate the technical steps and preliminary outcome of a novel bariatric procedure, the single-anastomosis plication ileal bypass (SAPI), for the treatment of morbid obesity.

Materials and Methods: Totally, 5 female patients with morbid obesity underwent SAPI procedure. The procedure consisted of 2 steps; the first step involved greater curvature plication done in a standardized manner, and the second step involved performing a stapled side-to-side anastomosis between an ileal loop 300 cm distal to the duodenojejunal junction and the gastric antrum. Body mass index (BMI) and percentage excess weight loss (%EWL) at 4 months postoperatively were measured.

Results: The median age of patients was 38 years. The mean preoperative BMI decreased from 47.3±7.1 kg/m2 to 36.3±6.1 at 4 months, postoperatively. The mean %EWL at 4 months after SAPI was 51.5±10.8. The mean operation time was 66±5.47 minutes. The median hospital stay was one day. No postoperative complications were recorded.

Conclusions: Despite the small numbers included, the preliminary results of this report show that SAPI is a promising bariatric procedure that achieved significant decrease in BMI and satisfactory excess weight loss. Long-term follow-up of larger number of patients is necessary to reach more firm conclusions on the efficacy and safety of this novel technique.

General Surgery Department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura City, Egypt

The authors declare no conflicts of interest.

Reprints: Sameh Emile, MD, Colorectal Surgery Unit, General Surgery Department, Mansoura University Hospitals, ElGomhouria street, Mansoura 35516, Egypt (e-mail:

Received September 10, 2018

Accepted October 30, 2018

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