Zaveri H, et al. - The mid-term outcomes of single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) bypass surgery after sleeve gastrectomy. A prospective database from four institutions yielded data of 96 patients for inclusion. Researchers divided the patients into two groups: one had two-stage SADI because of insufficient weight loss, the second had planned two-stage SADI because of super obesity (BMI > 50 kg/m²). They observed postoperative early complication rate of 5.3% and late complication rate of 6.4%. Higher %weight loss and change in BMI units were evident in group 2 vs group 1 at 24 months, with a statistically significant difference. Observations suggest the two-stage approach to SADI-S vs a single compromised operation as technically simpler. However, understanding of the limitations related to this approach is required among more patients.