Sleeve gastrectomy is clearly related to gastroesophageal reflux and esophagitis. This complication may apply also for malabsorptive procedures that include sleeve gastrectomy as SADIS.
We present a case of a staged SADI-S who presented de novo severe reflux. Patient was studied and a severe reflux with altered manometry and pHmetry. Patient did not response for conservative management. The patient was converted to RYGB.
After examining the anatomy of the SADI-S no hiatal hernia was found. The sleeve was fine and a little bit dilated. The Duodeno-Ileal anastomosis was dissected and sectioned. Next the distal stomach was dissected up to the point of section for the new pouch. The distal stomach was completely resected. Finally, a conventional simplified RYGB was completed. Patient did well and was discharged with improving of symptoms.
Conversion from SADI-S to RYGB is technically feasible and a practical option for patient developing new onset of gastroesphageal reflux.