Robotic conversion of sleeve gastrectomy to single anastomosis sleeve ileal bypass (SASI): feasibility and one-year outcomes.

Authors

Mathusan Sureshkumar, Ronald Denis, Alexis Deffain, Adam Di Palma, Radu Pescarus, Pierre Y Garneau, Anne-Sophie Studer

Published in

Journal of robotic surgery. Volume 20. Issue 1. Jun 19, 2026. Epub Jun 19, 2026.

Abstract

The objective was to assess feasibility, perioperative safety, and one-year outcomes for weight loss, resolution/remission of obesity related diseases, early and late morbidity of robot-assisted conversion from laparoscopic sleeve gastrectomy (LSG) to single anastomosis sleeve ileal bypass (SASI). A single-center analysis of robotic conversion SASI after LSG conducted from 2023 to 2025. Intra-operative details and early morbidity were described using Dindo-Clavien's classification. One-year outcomes were analyzed in patients who had reached the 12-months postoperative follow-up at the time of analysis. 51 patients (42 F/9 M, mean age: 46.3 ± 9.2yo), with a mean pre-operative BMI = 43.3 ± 7.8 kg/m² underwent SASI, either for recurrent weight gain (RWG: 68.6%) or suboptimal clinical response (SCR: 31.4%). Median time after LSG was 62.5 months (IQR: 66.5). Mean operative time was 112.4 ± 33.7 min and same day discharge was possible for 78.4% of patients. There were five emergency departement visits (9.8%) for minor complications (five Dindo-Clavien grade 1) and no major complications at 30 days postoperative. At 1-year postoperative, 76.5% of patients had available follow-up data. From the time of primary LSG, the %EWL and %TWL were 66.7 ± 22.2% and 34.2 ± 10.9%, respectively. Revisional surgery was required for two patients with refractory gastroesophageal reflux disease (GERD: 3.9%). In our high-volume center, robotic conversion SASI after LSG offers a feasible and safe approach with acceptable one-year postoperative outcomes, whether for RWG or SCR, with low morbidity.

PMID:
42319717
Bibliographic data and abstract were imported from PubMed on 19 Jun 2026.

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