SASI Bypass in Sharjah

What is SASI bypass?

SASI bypass is a newer metabolic operation built in two parts during one procedure. First the stomach is shaped into a sleeve. Then a loop of the ileum, the final section of the small intestine, is brought up and joined side to side onto the lower end of the sleeve, just above the stomach outlet. The normal passage out of the stomach into the duodenum stays open.

That design gives food a choice of two paths. Part of each meal travels the usual way through the duodenum and the whole small intestine, and part takes the short cut straight into the ileum. Food arriving early in the ileum triggers gut hormones that increase fullness and improve how the body handles sugar, which is why SASI is often discussed as an operation for diabetes as much as for weight.

A practical advantage patients rarely hear about: because the duodenum stays connected to the stomach, the bile duct and the upper bowel remain within reach of a standard camera test in future. The bariatric surgery overview page sets out the wider picture; Dar Al Kamal Hospital, Sharjah offers SASI bypass within its general and laparoscopic surgery service.

Who needs it

SASI bypass is considered for adults who meet the general BMI criteria for weight-loss surgery, usually a BMI of 40 or above, or 35 or above with a weight-related illness, and particularly for people whose type 2 diabetes is a central concern. It may also be discussed for people who would benefit from a sleeve but want a stronger metabolic effect without the full rerouting of a gastric bypass.

The alternatives are a sleeve gastrectomy alone, a Roux-en-Y or mini gastric bypass, and the more absorptive SADI-S. SASI has a shorter track record than the sleeve and the Roux-en-Y bypass, and your surgeon explains what the available evidence covers. The decision weighs your BMI, how your diabetes is controlled, any reflux, the medicines you rely on and your commitment to follow-up.

What happens

SASI bypass is performed under general anaesthesia by keyhole surgery. The surgeon first staples the stomach into a sleeve over a calibration tube and removes the outer part. The small intestine is then measured back from the point where it meets the large bowel, and that loop of ileum is joined to the front of the lower stomach with a single connection.

The staple line and the join are checked for leaks before the small cuts are closed. You wake in the recovery area, start sips of water when the team advises, and walk early to help the bowel recover and prevent clots. You go home when you are drinking well and your pain is controlled.

Preparing for it

Diabetes control is central to preparing for SASI bypass. Your diabetes medicines are reviewed carefully, because food intake drops sharply after surgery and some tablets and insulin doses need reducing from the day of the operation. A plan for checking your blood sugar at home is agreed before you are admitted.

A dietitian at Dar Al Kamal Hospital, Sharjah prepares you for the staged diet, and a short liver-reducing diet may be advised. A psychological evaluation is arranged as part of your care pathway, and blood tests set a baseline for vitamins, iron and protein. Stop smoking well in advance. If Ramadan is approaching, schedule the operation so the healing months fall outside it.

Afterwards

The diet moves from fluids through purée and soft food to small meals, with protein first. Some people find their bowel habit changes, with softer or more frequent stools after fatty meals, which usually settles as the diet does. Blood sugar is checked often in the early weeks, and diabetes medicines are adjusted as readings fall.

Lifelong vitamins and minerals are part of SASI: a multivitamin, calcium with vitamin D, vitamin B12 and iron, with blood tests at each follow-up, including fat-soluble vitamins. In later Ramadans, fasting is planned with your team, paying attention to low blood sugar during long hot days if you still take diabetes medicines. Your surgeon agrees a timeline for work and driving.

Contact the hospital urgently if you have a fever, a fast heart rate, worsening abdominal pain, repeated vomiting, or blood sugar readings that stay very low or very high. **Go to the emergency department straight away if you have chest pain, breathlessness, confusion or a painful, swollen leg.**

Cost and insurance

SASI bypass needs insurance pre-approval, and many UAE plans exclude weight-loss surgery. As a newer procedure, SASI may be assessed differently from a sleeve or Roux-en-Y bypass, so confirm the exact procedure name with your insurer. Criteria usually include documented BMI, diabetes records, supervised weight management, and dietitian and psychological assessments. Dar Al Kamal Hospital, Sharjah can help check your cover on 06 599 7777.