Transit bipartition surgery is an advanced metabolic surgical method preferred for the treatment of Type 2 diabetes, even in patients without excess weight.

In this surgery, 70% of the stomach volume is rendered non-functional via sleeve gastrectomy, which stops the secretion of the hunger hormone Ghrelin, thereby eliminating the desire to eat. Additionally, hormones like Incretin (GLP-1, Oxyntomodulin, PYY), which regulate insulin secretion from the pancreas, are released from the Ileum, a section of the small intestine near the large intestine. Therefore, it is necessary for the Ileum to encounter undigested food earlier in the digestive process. To achieve this, a portion of the Ileum is measured from the junction with the large intestine and then an anastomosis is created with the wider gastric sleeve part of the stomach. The aim is both to reduce absorption and to increase Incretin secretion, thereby breaking insulin resistance. Since absorption is gently altered, the side effects related to the digestive system are quite limited.

As a result, with transit bipartition surgery, blood sugar control is achieved by stimulating the hormones in the small intestine.

Effects of Transit Bipartition Surgery

In many studies conducted in the 1990s, it was noted that the increased absorption in the initial parts of the digestive system led to enterohormonal diseases and diabetes. A paper published in 1998 mentioned that diabetes is actually a disease of the foregut, the first part of the digestive system. Sergio Santoro’s paper indicated that high glycemic index foods cause hormonal hyperactivity in the early parts of the digestive system and hypoactivity in the later parts. Transit bipartition was developed to correct this imbalance.

Results of Transit Bipartition Surgery

With transit bipartition surgery, the pressure inside the stomach is significantly reduced, preventing leaks in the created gastric sleeve. After transit bipartition surgery, nearly 90% of properly selected Type 2 diabetes patients discontinue treatment, while the remainder can control their condition with only medication. Transit bipartition is an effective surgery that results in fast, effective, and permanent weight loss, as well as significant improvement in metabolic diseases.

Advantages of Transit Bipartition Surgery

The loop transit bipartition, developed using data from previous methods, is at least as effective as other surgeries in treating Type 2 diabetes, while being a relatively lower-risk variation. This method is technically simple, safe, and its greatest advantage is that it does not cause deep vitamin and mineral deficiencies.

This highly advantageous procedure is widely preferred and recommended today. The advantages of transit bipartition include:

• The integrity of the stomach and duodenum is preserved during the operation.
• If needed, any kind of endoscopic procedure can be performed after the surgery.
• Strong hormonal activity allows the patient to return to normal life in a short time.

How is the Loop Transit Bipartition (SASI – Single Anastomosis Sleeve Ileal Bypass) Surgery Performed?

During transit bipartition surgery, performed using the laparoscopic method, small incisions are made in the abdominal area. The recovery process after this closed technique surgery is faster compared to open surgery. First, sleeve gastrectomy is performed during the transit bipartition surgery. Then, while preserving the first 250 cm of the 5-meter-long small intestine, the small intestine is cut from the marked part. The cut portion is integrated into the reduced stomach, and the remaining part is connected to the last 150 cm of the small intestine. The aim of transit bipartition surgery is to control blood sugar without medication, especially in Type 2 patients who are close to or at normal weight. In this way, blood sugar control is achieved while maintaining the normal anatomy and structure of the duodenum.

In this surgery, 70% of the stomach volume is rendered non-functional via sleeve gastrectomy. This prevents the secretion of the hunger hormone Ghrelin, eliminating the desire to eat.