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4th INTERNATIONAL CONSENSUS SUMMIT FOR SLEEVE GASTRECTOMY V: Conversions standard Roux-en-Y gastric bypass (RYGB), banding the sleeve, plication of the sleeve, or re-sleeve. REFERENCES 1. 2. 3. 4. FIGURE 1. SADI-s. A sleeve gastrectomy is followed by a duodenal-ileal diversion at 200cm from the ileoceal junction. levels of hemoglobin or hematocrit, and 22 percent had low iron levels. After BPD, the estimated prevalence of anemia is around 40 percent, which can be reduced to five percent with proper iron and folate administration.3 Marceau et al4 reported a 14-percent rate of moderate anemia after duodenal switch. No clinical malnutrition was detected in this study. In summary, in our opinion, SADI-S comprises all the possible mechanisms involved in obesityrelated metabolic comorbidities improvement: moderate gastric restrictions; moderate reduction in the caloric intake; a bypass of the duodeno-pancreas; a rapid entrance of undigested chymus into the distal intestine; selective fat malabsorption; and in, the short run, maintained weight loss. Patients with T2DM who have undergone SADI-s have seen complete resolution their condition after the sixth postoperative month.5 They are able to maintain normal levels of glycosylated hemoglobin with no need of specific therapy or diet.5 The previously commented arguments explain the improvement of the lipidic profile. 5. Sánchez-Pernaute A, Rubio Herrera MA, Pérez-Aguirre E, et al. Proximal duodenal-ileal endto-side bypass with sleeve gastrectomy: proposed technique. Obes Surg. 2007;17:1614–8. Sánchez-Pernaute A, Rodríguez R, Rubio MA, et al. Gastric tube volume after duodenal switch and its correlation to short-term weight loss. Obes Surg. 2007;17:1178–1182. Scopinaro N, Adami GF, Marinari GM, et al. Biliopancreatic diversion. World J Surg. 1998;22:936–946. Marceau P, Biron S, Hould F-S, et al. Duodenal switch: long-term results. Obes Surg. 2007;17:1421–430. Sánchez-Pernaute A, Herrera MA, Pérez-Aguirre ME, et al. Singleanastomosis duodeno-ileal bypass with sleeve gastrectomy (SADIS). Metabolic improvement and weight loss in the first 100 patients. Surg Obes Relat Dis. 2012 Aug 7. [Epub ahead of print] CONCLUSION SADI-S has proven to be a good (based on solid physiopathologic principles), second-step procedure after a "failed" LSG. Nevertheless, longer follow up is necessary and prospective studies are needed to determine the potential of this operation in comparison with May 2013 • Supplement A • Bariatric Times A21