SASI Procedure (Single-Anastomosis Sleeve Ileal Bypass)

Classic gastric bypass surgery is not merely another surgical procedure for treating obesity; it is considered a smart approach that combines the power of sleeve gastrectomy with the precision of gastric bypass in a single procedure, providing effective weight loss while reducing the risk of malabsorption and nutritional deficiencies.

When performed at a specialized center such as Matar Clinic under the supervision of Professor Dr. Mohamed Matar, SASI surgery for weight loss becomes more than just a surgical procedure; it becomes a comprehensive program to rebuild your health and lifestyle from the ground up.

What Is SASI Surgery (Single-Anastomosis Sleeve Ileal Bypass)?

SASI surgery, medically known as Single-Anastomosis Sleeve Ileal Bypass (SASI), is a relatively modern surgical procedure that emerged in 2010. It aims to combine the benefits of sleeve gastrectomy and gastric bypass in a single procedure.
​
The procedure restricts food intake through sleeve gastrectomy while simultaneously reducing the absorption of some calories, fats, and sugars by connecting part of the stomach to the small intestine, while maintaining the passage of some food through the natural intestinal pathway to reduce the risk of severe vitamin and mineral deficiencies.
​

With this design, SASI surgery provides an important balance: significant weight loss and improvement in obesity-related conditions, with better control of malabsorption problems compared with traditional gastric bypass.

Read also: My Experience with SASI Surgery

How Is SASI Surgery Performed?

SASI surgery is performed under general anesthesia using a laparoscopic approach through small incisions in the abdomen. It usually takes 60 to 90 minutes when performed by an experienced bariatric surgeon such as Professor Dr. Mohamed Matar.
​
It can be performed as a primary procedure from the outset, or as a revisional procedure after a previous sleeve gastrectomy that did not achieve the desired results or was accompanied by problems such as acid reflux or weight stabilization.
​

The procedure consists of two main stages:

Sleeve Gastrectomy Stage

• The surgeon removes approximately 70–75% of the stomach, leaving a narrow tube shaped like a banana. This reduces the amount of food that can be consumed in one meal and decreases the secretion of the hunger hormone (ghrelin).
  ​
• This results in a faster feeling of fullness with smaller amounts of food, which is the foundation of any successful SASI weight-loss procedure.
  ​

Connecting the Stomach to the Intestine (Second Division)

• The lower part of the stomach (the newly created tube) is connected to a later segment of the small intestine, allowing some of the food to bypass a certain length of the intestine and reducing the absorption of fats, sugars, and carbohydrates.
  ​
• At the same time, some of the food continues to pass through the natural pathway via the duodenum and the beginning of the intestine, preserving a good portion of nutrient absorption and reducing the risk of severe nutritional deficiencies compared with classic gastric bypass.
  ​
• At the end of the procedure, a leak test is performed to ensure the integrity of the connections and the sleeve staple line before completing the surgery and moving the patient to recovery.

​

When Can SASI Surgery Be Considered?

SASI surgery is an option among bariatric procedures for patients with significant excess weight or obesity accompanied by related medical conditions who are seeking a solution that combines effective weight loss with a reduced risk of nutritional deficiencies.
​

Cases Suitable for SASI Surgery

• When the body mass index (BMI) is between 35–40, with or without obesity-related conditions, or 30 or higher in the presence of weight-related health problems such as:
  ​
  High blood pressure
• Type 2 diabetes or insulin resistance
• High cholesterol and triglyceride levels
• Difficulty breathing during sleep (sleep apnea)
• Obesity-related heart disease and joint pain

For patients who have undergone sleeve gastrectomy but did not achieve the desired results or regained weight, SASI surgery may be used as a carefully considered revisional solution.
​

At Matar Clinic, Professor Dr. Mohamed Matar evaluates each case individually through a detailed medical examination, review of the patient’s medical history, and laboratory tests to determine whether SASI surgery is the most appropriate option or whether another procedure would be more suitable.

What Are the Benefits and Disadvantages of SASI Surgery?

What Is the Difference Between Gastric Bypass and SASI?

Both procedures may appear similar in their general concept (reducing stomach size and altering the pathway of part of the food), but there are fundamental differences in their absorption mechanisms and vitamin requirements.

A Table Showing the Difference Between Classic Gastric Bypass and SASI Surgery

Professor Dr. Mohamed Matar explains the advantages and disadvantages of each option to the patient, then chooses between SASI surgery or another type of bariatric procedure based on eating habits, the severity of obesity, and associated medical conditions.

What Is the Cost of SASI Surgery in Egypt? And Is Installment Payment Available?

There is no fixed price for bariatric surgery in general or SASI surgery in particular, as the cost varies depending on several factors, the most important of which are:

​

• Hospital facilities and operating room equipment
• The experience and fees of Professor Dr. Mohamed Matar and the anesthesia team
• The type and quality of the staplers, laparoscopic equipment, and instruments used
• The cost of pre- and post-operative examinations
• The strength of the post-operative follow-up, nutrition, and support program.
  ​

At Matar Clinic, high-quality precision surgical laparoscopic equipment and smart American-made staplers are used, along with an integrated medical team providing surgical, nutritional, and psychological follow-up. This reflects the true value of the service, not just the price.
​

You can contact Matar Clinic to learn about the updated price of SASI surgery in Egypt, the best available offers, installment options, and payment facilities that suit your circumstances.

Read also: Best Gastric Bypass Surgeon in Egypt

Diet After SASI Surgery

The diet after SASI surgery is an essential part of the procedure’s success, not merely secondary instructions.

Initially, the patient starts with clear liquids (water, clear broth), followed by full liquids that are richer in protein, according to the nutritionist’s instructions.

The patient then gradually progresses to soft and pureed foods, followed by the gradual introduction of solid foods, with an emphasis on proteins (lean meat, chicken, and fish, eggs, low-fat dairy products), as well as suitable vegetables and fruits.

The Matar Clinic team emphasizes the importance of taking vitamins and nutritional supplements during the initial period after surgery and monitoring laboratory tests to adjust dosages as needed, ensuring healthy and safe weight loss without nutritional deficiencies.

This dietary program is individually tailored for each patient by the center’s nutrition team to suit their health needs and lifestyle.

Which Is Better | Sleeve Gastrectomy or SASI?

There is no single procedure that is suitable for everyone. Therefore, Professor Dr. Mohamed Matar clearly explains the differences and then selects the most appropriate procedure for you based on your laboratory results, eating habits, and ultimate weight-loss goal.

​Does Weight Return After SASI Surgery?

Some weight may return if the patient neglects the dietary plan, consumes excessive amounts of sugars and fats, or stops medical follow-up, as can happen with any bariatric surgery.
​

However, the design of SASI surgery for weight loss makes weight regain more difficult compared with sleeve gastrectomy alone, especially when following Matar Clinic’s dietary and physical activity instructions over the long term.

Continuous follow-up with the Matar Clinic team and joining support groups improve the chances of maintaining the results and avoiding a return to the starting point.

How Long Does SASI Surgery Take?

SASI surgery usually takes approximately 60 to 90 minutes and is performed entirely laparoscopically through small incisions in the abdomen, which helps reduce pain, accelerate recovery, and shorten the hospital stay.
​

In most cases, the patient can leave the hospital within one or two days and gradually return to daily activities within approximately one week, according to the doctor’s instructions.

Weight Loss Rate After SASI Surgery

Available studies and patient experiences indicate that the weight loss rate after SASI surgery may reach a significant percentage of excess weight loss during the first 12–18 months, with noticeable improvements in health indicators such as blood sugar, blood pressure, and lipid levels.
​

This rate depends on the patient’s adherence to the dietary plan, physical activity, and regular attendance at follow-up appointments at Matar Clinic.

Is SASI Surgery Dangerous?

Like any major bariatric surgery, SASI surgery carries potential risks such as bleeding, leakage, infection, or blood clots, but these risks remain low when the procedure is performed at specialized centers by experienced surgeons.
​

From a nutritional perspective, deficiencies in certain vitamins and minerals may occur if the patient does not adhere to supplementation and follow-up. Therefore, Matar Clinic provides a precise program of regular laboratory testing and therapeutic nutrition.

Before surgery, Professor Dr. Mohamed Matar explains to the patient both the “bright side and dark side” of SASI, enabling them to make a clear and responsible decision.

Does SASI Surgery Affect Pregnancy?

Pregnancy is generally advised to be postponed after any bariatric surgery, including SASI surgery, for at least 12–18 months until weight stabilizes and the body regains its nutritional balance.
​

After this period, with proper monitoring of vitamin and mineral levels, pregnancy and maternal health may improve compared with the period of obesity, as weight loss can help reduce the risks of gestational diabetes, high blood pressure, and breathing problems.

At Matar Clinic, coordination takes place between the bariatric surgeon, obstetrician-gynecologist, and nutritionist to help ensure a safe pregnancy after surgery at the appropriate time.

Is SASI the Best Choice for You?

If you are looking for a powerful solution for obesity that combines the benefits of sleeve gastrectomy and gastric bypass, focuses on weight loss and improving blood sugar while reducing malabsorption problems, SASI surgery may be the smart choice for your case.
​

Contact Matar Clinic now to schedule a consultation with Professor Dr. Mohamed Matar and find out whether SASI surgery is suitable for you, learn about the diet after SASI surgery and your expected rate of weight loss, and receive a comprehensive follow-up plan designed to help you gain the maximum benefit from the surgery safely and confidently.