SIPS surgery explained

Stomach Intestinal Pylorus-Sparing (SIPS) surgery is a type of weight-loss surgery. It was developed in 2013 by two U.S. surgeons, Daniel Cottam^[1] from Utah and Mitchell S. Roslin from New York.^[2]

It is substantively the same procedure as the SADI surgery.

Technique

SIPS surgery is a modified version of duodenal switch (DS) surgery. The SIPS surgery involves the creation of a 300-cm common channel with a single-anastomosis duodenal enterostomy.

Advantages

1. Greater weight loss than sleeve gastrectomy (SG).
2. Greater weight loss than Roux-en-Y gastric bypass (RYGB).
3. Weight loss is similar to DS.
4. One of the best revision surgeries after failed RYGB, adjustable gastric banding (ABG), and SG.
5. Better T2DM remission than RYGB and SG.
6. Better cholesterol resolution than RYGB.
7. No Roux limb side effects.
8. Similar nutritional problems to RYGB and less than DS.
9. Low risk of intestinal obstruction compared to RYGB and DS.
10. No Dumping syndrome, unlike RYGB.
11. No marginal ulcers, unlike RYGB.

Disadvantages

1. Long-term data are not available.
2. Procedure is still considered experimental in nature and not covered by insurance companies.
3. Malabsorptive procedure [needs closer nutritional follow-up].
4. <1% incidence of bile reflux.

See also

SADI-S surgery

References

1. Web site: Dr. Cottam Bariatric Surgeon Salt Lake City, Utah Sleeve Gastrectomy Provo. www.surgicalweightlossspecialist.com. 2019-12-23.
2. Web site: Dr. Mitchell Roslin . Northern Westchester Hospital, Mt Kisco NY. nwhsurgicalweightloss.org. 2019-12-23.

Further reading

• Amit Surve, MD, Hinali Zaveri, MD, Daniel Cottam, MD, Christina Richards, MD, FACS, Walter Medlin, MD, FACS, Austin Cottam. Laparoscopic Stomach Intestinal Pylorus Sparing Surgery in a Patient with Morbid Obesity and Situs Inversus; First Video Case Report. Surg Obes Relat Dis. 2016. (Article in Press)
• 27317604. 2016. Surve. A.. A video case report of stomach intestinal pylorus sparing surgery with laparoscopic fundoplication: A surgical procedure to treat gastrointestinal reflux disease in the setting of morbid obesity. Surgery for Obesity and Related Diseases . 12. 5. 1133–1135. Zaveri. H.. Cottam. D.. 10.1016/j.soard.2016.04.001.
• 26543731. 4628040. 2015. Zaveri. H.. Stomach intestinal pylorus sparing surgery (SIPS) with laparoscopic fundoplication (LF): A new approach to gastroesophageal reflux disease (GERD) in the setting of morbid obesity. SpringerPlus. 4. 596. Surve. A.. Cottam. D.. Richards. C.. Medlin. W.. Belnap. L.. Cottam. S.. Cottam. A.. 10.1186/s40064-015-1396-6 . free .
• 27396548. 2016. Surve. A.. Mid-term outcomes of gastric bypass weight loss failure to duodenal switch. Surgery for Obesity and Related Diseases . 12. 9. 1663–1670. Zaveri. H.. Cottam. D.. Belnap. L.. Medlin. W.. Cottam. A.. 10.1016/j.soard.2016.03.021.
• 26992894. 2016. Cottam. A.. A Matched Cohort Analysis of Sleeve Gastrectomy with and Without 300 cm Loop Duodenal Switch with 18-Month Follow-Up. Obesity Surgery. 26. 10. 2363–9. Cottam. D.. Roslin. M.. Cottam. S.. Medlin. W.. Richards. C.. Surve. A.. Zaveri. H.. 10.1007/s11695-016-2133-0. 19660687 .
• 27568033. 2017. Cottam. A.. A Matched Cohort Analysis of Stomach Intestinal Pylorus Saving (SIPS) Surgery Versus Biliopancreatic Diversion with Duodenal Switch with Two-Year Follow-up. Obesity Surgery. 27. 2. 454–461. Cottam. D.. Portenier. D.. Zaveri. H.. Surve. A.. Cottam. S.. Belnap. L.. Medlin. W.. Richards. C.. 10.1007/s11695-016-2341-7. 23644591 .
• 27156009. 2016. Surve. A.. A safer and simpler technique of duodenal dissection and transection of the duodenal bulb for duodenal switch. Surgery for Obesity and Related Diseases . 12. 4. 923–924. Zaveri. H.. Cottam. D.. 10.1016/j.soard.2016.02.022. free.
• 27134196. 2016. Surve. A.. Retrograde filling of the afferent limb as a cause of chronic nausea after single anastomosis loop duodenal switch. Surgery for Obesity and Related Diseases . 12. 4. e39–e42. Zaveri. H.. Cottam. D.. 10.1016/j.soard.2016.01.018. free.
• 26932811. 2016. Mitzman. B.. Stomach Intestinal Pylorus Sparing (SIPS) Surgery for Morbid Obesity: Retrospective Analyses of Our Preliminary Experience. Obesity Surgery. 26. 9. 2098–2104. Cottam. D.. Goriparthi. R.. Cottam. S.. Zaveri. H.. Surve. A.. Roslin. M. S.. 10.1007/s11695-016-2077-4. 7737567 .
• 26694182. 2016. Cottam. A.. A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up. Surgical Endoscopy. 30. 9. 3958–64. Cottam. D.. Medlin. W.. Richards. C.. Cottam. S.. Zaveri. H.. Surve. A.. 10.1007/s00464-015-4707-7. 27911781 .
• 26433641. 2016. Summerhays. C.. Internal hernia after revisional laparoscopic loop duodenal switch surgery. Surgery for Obesity and Related Diseases . 12. 1. e13-5. Cottam. D.. Cottam. A.. 10.1016/j.soard.2015.08.510. free.