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SASI bypass results in mean total weight loss of 35.9 kg after 12 monthsBariatric Surgery Option Shows Strong Weight Loss

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Key Takeaway
Note that SASI bypass results in 35.9 kg mean weight loss at 12 months, though evidence certainty is low.

This meta-analysis evaluates weight loss and metabolic outcomes in patients undergoing bariatric surgery, specifically comparing single-anastomosis sleeve ileal (SASI) bypass against sleeve gastrectomy, one-anastomosis gastric bypass, and Roux-en-Y gastric bypass. The analysis included a total sample size of 1603 patients across various surgical techniques.

The primary finding indicates that patients undergoing SASI achieved a mean total weight loss of 35.9 kg (95% CI 33.3-38.5) at the 12-month follow-up point. Secondary outcomes such as metabolic, nutritional, and safety profiles were also assessed but specific pooled values for these metrics are not provided in the summary data.

The authors note that the certainty of evidence for 1-year outcomes is low to very low according to GRADE assessment. This limited confidence stems from a mix of randomized controlled trials and non-randomized comparative studies. Clinicians should interpret these findings with caution due to the low certainty of evidence.

A new analysis looked at how well a newer type of weight-loss surgery, called single-anastomosis sleeve ileal (SASI) bypass, works compared with other common bariatric procedures. The researchers combined results from 1,603 patients who had SASI, sleeve gastrectomy, one-anastomosis gastric bypass, or Roux-en-Y gastric bypass. They focused on weight loss after 12 months.

The analysis found that people who had SASI bypass lost an average of 35.9 kg (about 79 pounds) in the first year. This is a large amount of weight loss, but the researchers caution that the quality of the evidence is low to very low. That means the true effect could be different.

The study included both randomized trials and non-randomized studies, which can make the results less reliable. Also, the researchers did not report on safety issues like complications or side effects, so it is not clear how safe SASI is compared with other procedures.

For anyone considering weight-loss surgery, this finding is promising but not definitive. More high-quality studies are needed to confirm how well SASI works and to understand its risks. Always talk to your doctor about the best options for your situation.

What this means for you:
SASI bypass may lead to significant weight loss, but evidence is low certainty.

Common questions

What is SASI bypass?

SASI stands for single-anastomosis sleeve ileal bypass. It is a type of weight-loss surgery that combines a sleeve gastrectomy with a bypass of part of the intestine. This analysis compared it to other common bariatric procedures.

Is SASI bypass safe?

The analysis did not report on safety issues like complications or side effects. So it is not clear how safe SASI is compared with other procedures. Talk to your doctor about the risks and benefits.

Study Details

Study typeMeta analysis
Sample sizen = 1,603
EvidenceLevel 1
Follow-up12.0 mo
PublishedAug 2026
View Original Abstract ↓
Single anastomosis sleeve ileal (SASI) bypass combines sleeve gastrectomy with intestinal bipartition to promote weight loss and metabolic improvement. We conducted a systematic review and meta-analysis comparing SASI with sleeve gastrectomy (1 RCT and 4 non-randomized comparative studies (NRCTs)), one-anastomosis gastric bypass (2 RCTs, 4 NRCTs), and Roux-en-Y gastric bypass (2 NRCTs), regarding weight loss, metabolic and nutritional outcomes, and adverse effects. Certainty of evidence was assessed with GRADE for 1-year outcomes. Twenty-six studies (1603 patients) were included, mostly reporting 12-month results. Pooled single-arm analysis from 11 studies showed mean total weight loss of 35.9 kg (95% CI 33.3-38.5). The certainty of evidence ranged from low to very low, limiting confidence in the results and emphasizing the need for high-quality RCTs.
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