SIPS surgery

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 from Utah and Mitchell S. Roslin from New York.

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.

External image
SIPS Surgery Image

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

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)
• Surve, A.; Zaveri, H.; Cottam, D. (2016). "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. doi:10.1016/j.soard.2016.04.001. PMID 27317604.
• Zaveri, H.; Surve, A.; Cottam, D.; Richards, C.; Medlin, W.; Belnap, L.; Cottam, S.; Cottam, A. (2015). "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. doi:10.1186/s40064-015-1396-6. PMC 4628040. PMID 26543731.
• Surve, A.; Zaveri, H.; Cottam, D.; Belnap, L.; Medlin, W.; Cottam, A. (2016). "Mid-term outcomes of gastric bypass weight loss failure to duodenal switch". Surgery for Obesity and Related Diseases. 12 (9): 1663–1670. doi:10.1016/j.soard.2016.03.021. PMID 27396548.
• Cottam, A.; Cottam, D.; Roslin, M.; Cottam, S.; Medlin, W.; Richards, C.; Surve, A.; Zaveri, H. (2016). "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. doi:10.1007/s11695-016-2133-0. PMID 26992894. S2CID 19660687.
• Cottam, A.; Cottam, D.; Portenier, D.; Zaveri, H.; Surve, A.; Cottam, S.; Belnap, L.; Medlin, W.; Richards, C. (2017). "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. doi:10.1007/s11695-016-2341-7. PMID 27568033. S2CID 23644591.
• Surve, A.; Zaveri, H.; Cottam, D. (2016). "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. doi:10.1016/j.soard.2016.02.022. PMID 27156009.
• Surve, A.; Zaveri, H.; Cottam, D. (2016). "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. doi:10.1016/j.soard.2016.01.018. PMID 27134196.
• Mitzman, B.; Cottam, D.; Goriparthi, R.; Cottam, S.; Zaveri, H.; Surve, A.; Roslin, M. S. (2016). "Stomach Intestinal Pylorus Sparing (SIPS) Surgery for Morbid Obesity: Retrospective Analyses of Our Preliminary Experience". Obesity Surgery. 26 (9): 2098–2104. doi:10.1007/s11695-016-2077-4. PMID 26932811. S2CID 7737567.
• Cottam, A.; Cottam, D.; Medlin, W.; Richards, C.; Cottam, S.; Zaveri, H.; Surve, A. (2016). "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. doi:10.1007/s00464-015-4707-7. PMID 26694182. S2CID 27911781.
• Summerhays, C.; Cottam, D.; Cottam, A. (2016). "Internal hernia after revisional laparoscopic loop duodenal switch surgery". Surgery for Obesity and Related Diseases. 12 (1): e13-5. doi:10.1016/j.soard.2015.08.510. PMID 26433641.