Ileal interposition

Ileal Interposition is a Metabolic Surgery procedure, used to treat overweight diabetic patients through surgical means. First presented by the Brazilian surgeon Aureo De Paula in 1999, this technique is applied by placing ileum, which is the distal part of the small intestine, either between stomach and the proximal part of the small intestine (1) or by placing the ileum to the proximal part of the small intestine without touching the natural connections of the stomach (2). There are 2 different versions of the operation. Sleeve gastrectomy procedure is standard for both of the versions. Ileal Interposition is a Metabolic Surgery procedure, used to treat overweight diabetic patients through surgical means. First presented by the Brazilian surgeon Aureo De Paula in 1999, this technique is applied by placing ileum, which is the distal part of the small intestine, either between stomach and the proximal part of the small intestine (1) or by placing the ileum to the proximal part of the small intestine without touching the natural connections of the stomach (2). There are 2 different versions of the operation. Sleeve gastrectomy procedure is standard for both of the versions. In addition to sleeve gastrectomy procedure, the connection between the stomach and the duodenum is closed off from the level of the second segment of the duodenum. While preserving the last 30 cm part of the small intestine, a 170 cm segment of ileum is prepared and connected to the first segment of the duodenum, which is at the end of the stomach. The other end of the ileum segment is connected to the proximal part of the small intestine. Thus, distal part of the small intestine is ‘’interposed’’ between proximal part of the small intestine and the stomach. Since duodenum and the proximal part of the small intestine is disabled, a partial bypass is in question. Patients who undergo this operation achieve better weight and blood sugar control, but face anemia (iron deficiency) risk because of the bypass procedure.