Mr. Srinadh used to weigh 147 kg. He underwent sleeve gastrectomy elsewhere in 2009. He lost 25 kg. But regained weight to 164 kg. On 16th Mar 2016, I performed revision bariatric surgery, Laparoscopic Single Anastomosis Duodeno-ileal Bypass (SADI) on him. On 05 Oct 2017, his weight was 81 kg, still losing. He is happy, healthy and fit.
Weight loss after bariatric surgery is mainly due to hormonal changes. Role of food restriction or mal-absorpiton is secondary. Sleeve gastrectomy is the most commonly performed obesity surgery worldwide. But significant number of individuals regain weight, even after properly performed gastric sleeve surgery. This is mainly due to hormonal adaptation. These individuals need addition of some form of ‘ileal diversion’ to ‘gastric sleeve’ as a ‘revision bariatric surgery’. This revision is necessary to restore significant hormonal changes needed to induce weight loss again and make that weight loss permanent. ‘Single anastomosis duodeno-ileal bypass’ (SADI) is one of the best revision surgeries which can induce weight loss again.