The rise of sleeve gastrectomy (SG) as the most commonly performed bariatric operation and the need for effective revisional surgery due to anticipated inadequate weight loss and co-morbidity control following SG has led many surgeons to contemplate adding SADI/LoopDS to their bariatric practice. Although the interest is high, safety and outcomes data are favorable, and ASMBS no longer considers SADI/LoopDS to be an investigational procedure, adoption of SADI/LoopDS remains slow. This course aims to address in depth three major barriers to implementation of SADI/LoopDS into today’s surgical practice: technical aspects of duodenal dissection, nutritional management in the setting of current bariatric practices, and appropriate positioning of SADI/LoopDS in the bariatric procedure selection algorithm. The primary audience for this course is surgeons and their teams that are in the contemplation stage of SADI/LoopDS implementation or are relatively early (< 30 cases) in their experience with this procedure.

Learning Objectives:

  1. Provide background on SADI/Loop DS physiology and mechanism of action.
  2. Describe the strengths and limitations of the surgical approaches to duodenal dissection including antropyloric mobilization, limited retroduodenal tunnel, and the role of robotic assistance.
  3. Discuss the relative impact of SADI/Loop DS on malabsorption and nutrition as compared to other procedures.
  4. Compare and contrast nutrition management strategies specific to SADI/Loop DS to those of other procedures.
  5. Summarize an evidence-based framework for SADI/Loop DS as a primary and revisional bariatric procedure.

3:15pm Introduction
Vivek Prachand, MD
3:17pm Loop DS Background
Vivek Prachand, MD
3:22pm "My Path to Loop DS"
Vivek Prachand, MD; Paul Enochs, MD; Megan Jenkins, MD
3:27pm Duodenal Dissection: Pyloric mobilization
Paul Enochs, MD
3:35pm Duodenal Dissection: Robotic approach
Megan Jenkins, MD
3:43pm Duodenal Dissection: Retroduodenal tunnel
Vivek Prachand, MD
3:51pm Duodenal Dissection Question and Answer
Vivek Prachand, MD; Paul Enochs, MD; Megan Jenkins, MD
3:59pm How malabsorptive is LoopDS?
Megan Jenkins, MD
4:09pm LoopDS and supplement strategy for your bariatric program
Heather Mackie, MS RDN LD
4:17pm Nutrition Discussion Question and Answer
4:25pm Where does LoopDS fit in the surgery algorithm?
Laurent Biertho, MD
4:35pm Discussion Question and Answer
4:44pm Closing Wrap-Up
Vivek Prachand, MD
4:45pm Adjourn