# Robotic-Assisted Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy – A Systematic Review

## TL;DR

This systematic review evaluates the outcomes of a robotic-assisted weight loss surgery called R-SADI-S, showing significant weight loss and few complications in patients with severe obesity.

## Contribution

The study provides the first systematic review of clinical and surgical outcomes for robotic-assisted R-SADI-S in severe obesity.

## Key findings

- Patients undergoing R-SADI-S achieved an average weight loss of 60.7 kg at 24 months.
- Only 7.5% of patients experienced postoperative complications, with 1.4% requiring reintervention or readmission.
- The mean surgery time was 181 minutes, and the average BMI decreased by 18.0 kg/m².

## Abstract

The anticipated surgical and postoperative outcomes following robotic-assisted single anastomosis duodeno-ileal bypass with sleeve gastrectomy (R-SADI-S) are not well described in the surgical literature.

To perform a systematic review to evaluate clinical and surgical outcomes in patients who have undergone R-SADI-S.

A systematic review was performed in accordance with the PRISMA guidelines. Basic descriptive statistics were performed using SPSS v26.0.

Overall, 4 studies including data from 160 patients were included. The mean age at the time of surgery was 38.1 years and 55.6% of patients were female (89/160). The mean reported preoperative weight was 122.2 kg and mean body mass index was 45.1 kg/m2. The mean time taken for R-SADI-S was 181 min and 7.5% of patients experienced postoperative complications (12/160), however, just 1.4% of patients required either reintervention and readmission (2/144) respectively. At 24-months follow-up, patients who had undergone-R-SADI-S experienced an average weight loss of 60.7 kg, a BMI change of -18.0 kg/m2, a total body weight loss of 44.6% and excess weight loss of 113.7%.

R-SADI-S is a seemingly safe procedure which provides excellent weight loss results when performed for patients living with severe obesity. Given R-SADI-S is a novel technique, these results require further ratification once the learning curve is navigated in prospective analyses to ensure the optimisation of patient outcomes.

The online version contains supplementary material available at 10.1007/s11695-026-08540-5.