By Dr. Matt Apel
SIPS stands for stomach intestinal pylorus sparing. This bariatric procedure is at times referred to as the single-anastomosis duodenal switch because it is a modified version of the procedure known as the duodenal switch (DS).
The purpose of SIPS is twofold. First, by removing the stomach’s stretchiest portion, we decrease the amount it can hold. Second, in bypassing a portion of the upper small intestine, we curb the number of calories absorbed into the body. The patented Safe Sleeve procedure, also called the vertical sleeve gastrectomy (VSG), is our first recommendation, but we also offer the SIPS for clients who need a little more help.
How stomach reduction causes weight loss after SIPS
Removing the stretchy upper portion of the stomach during the SIPS procedure makes it smaller and tube-shaped. Whereas it was formerly able to contain an average of one quart, it holds somewhere between four to six ounces post-surgery.
Despite the alterations to its shape and size, your stomach will continue to function as it did before. The antrum continues to pumps food out of the stomach, and the pylorus, which allows food to enter the small intestine, as well as the nerves that control these actions, all remain intact.
After the SIPS procedure, you will feel full more quickly. In fact, you are likely to be satisfied after consuming only four to six ounces. An additional benefit of removing the stomach’s stretchy portion is decreased levels of ghrelin, known as the hunger hormone. With less ghrelin in your system, you become hungry far less often.
How bypassing the small intestine achieves Calorie absorption after the SIPS procedure
After removing the upper portion of the stomach, we reroute the intestinal tract, allowing the food you eat to skip approximately half of your small intestine. Bypassing this part of the small intestine enables your body to absorb fewer calories.
Another advantage of rerouting the intestinal track is that food arrives at the lowest part of your small intestine more quickly. As the food you eat reaches this portion of your intestinal tract, it triggers your body to release appetite-suppressing hormones. The sooner these hormones are released, the sooner you feel satisfied.
Benefits and risks of the SIPS procedure
The SIPS procedure is minimally invasive and laparoscopic. Patients recover quickly and are able to return home two or three days after the procedure.
As mentioned earlier, the SIPS procedure is a modified version of the DS. It was designed to offer comparable weight-loss benefits to the DS procedure, but with fewer risks or complications. The newer SIPS procedure employs only one opening between the stomach and small intestine, while the DS involves two. Patients generally experience far less malabsorptive symptoms after undergoing SIPS because the common channel food travels is nearly twice the length of the channel created by the DS.
Gastric bypass is another bariatric surgery that involves rerouting the intestinal tract. The SIPS procedure is less invasive than gastric bypass because it allows the stomach’s pyloric valve to keep doing its job. When your pyloric valve functions as intended, your body can better control blood glucose and nutrient absorption. Thanks to the intestine-to-intestine connection employed during SIPS, fewer patients develop strictures or ulcers after this procedure than after a gastric bypass. Finally, because the food you eat is more adequately broken down after SIPS, your chance of food intolerances and “dumping” are much less likely after SIPS than after gastric bypass.
As for the benefits, most clients achieve 75 to 80 percent weight loss within one year of the SIPS procedure. Our clients also experience notable improvement and even complete resolution of obesity-related co-morbidities, such as type-2 diabetes, high cholesterol, high blood pressure, and sleep apnea. Many clients find the SIPS procedure also minimizes the symptoms of gastroesophageal reflux disease (GERD).
Is the SIPS procedure right for you?
In having dedicated postoperative support, most patients succeed in achieving long-term weight loss after the Safe Sleeve. We recommend this procedure first because it offers the lowest risk, and has an extremely high success rate. In the event that a patient fails to lose enough weight after the Safe Sleeve, or regains weight later, SIPS is a perfect next step. It offers patients the hope of a second chance.
We do not advise starting with SIPS because there is no second-chance procedure to fall back on afterward. Most people don’t even need to explore SIPS because they achieve the weight loss they hope for after the Safe Sleeve. Recidivism after the second chance provided by SIPS is incredibly rare, as are cases of clients needing a third chance.
Ideal candidates for SIPS are 50 pounds or more overweight, are non-smokers, have regular bowel movements, have not undergone previous abdominal operations, are not on medications they will need to continue after achieving their goal weight, and can adhere to a post-surgery supplement schedule. Those who often experience diarrhea, are smokers, require medications even after reaching their goal weight, and have difficulty taking their supplements as scheduled need further consultation to determine whether or not these issues can be resolved before surgery.
To learn more about either Safe Sleeve or SIPS, feel free to contact Blossom Bariatrics. Our medical experts are happy to discuss any questions you have concerning these weight-loss procedures.
Matthew E. Apel, MD, FACS, FASMBS completed his residency in General Surgery at the University of Arizona. He then joined the Division of General Surgery/Section of Minimally Invasive and Robotic Surgery at The University of Arizona as a Clinical Fellow. He is also certified in using the robotic da Vinci Surgical System as a Console Surgeon. Dr. Apel’s passion for bariatric surgery is rooted in his desire to help patients not only improve — or resolve — many of their medical conditions but also boost their self-esteem, quality of life, and overall happiness.