Investigational per IFSO 2022. I tell you up front.
A sleeve, two paths for food. The Brazilian technique that bets on gut hormones, not malabsorption. Still investigational — and that's why I tell you straight.
01 · What it is
Intestinal bipartition (Santoro technique) combines a sleeve gastrectomy with a side-to-side anastomosis between the proximal jejunum and the distal ileum. Food takes two paths: a short loop (direct access to the ileum) and a long loop (natural transit). The dual pathway is designed to amplify distal-gut hormonal signals — GLP-1 and PYY — for a strong metabolic effect.
Unlike a bypass, no intestinal segment is defunctionalized. There is a single anastomosis. The original idea was to shift hormonal physiology without the severe malabsorption of purely diversionary procedures.
It was described by Dr. Sergio Santoro in São Paulo, Brazil, and published in Annals of Surgery 2012. The available evidence comes primarily from case series.
Investigational status. IFSO classifies intestinal bipartition as an investigational procedure (Brown et al., Innovative Bariatric Procedures and Ethics in Bariatric Surgery: the IFSO Position Statement, Obesity Surgery 2022). That means long-term evidence (>5 years) is still being built, compared with standard procedures like RYGB or sleeve gastrectomy. ASMBS has not endorsed it as a primary standard procedure. Any honest conversation about this surgery starts there.
02 · Who it's for
These are general indications. Real candidacy depends on your medical history, willingness to accept investigational status, and a case-by-case conversation.
Patients seeking a metabolic approach based on intestinal transit reorganization and amplification of distal-gut hormonal signals.
Patients who prefer a procedure that does not defunctionalize intestinal segments — preserving natural transit alongside the short pathway.
Patients who have discussed the investigational status (IFSO 2022) with their surgeon and accept the risk-benefit balance versus options with more evidence (RYGB, sleeve, SADI-S).
If you need robust long-term evidence, or you're starting your bariatric journey without a specific indication, RYGB or sleeve gastrectomy are usually more appropriate starting points. We talk about that before surgery — not after.
03 · The procedure
Cardiology and anesthesiology evaluation. Nutritional assessment with a clinical nutritionist. Psychological evaluation with a bariatric psychologist. Detailed informed-consent discussion, including investigational status per IFSO 2022.
Laparoscopic operation under general anesthesia. Sleeve gastrectomy followed by side-to-side anastomosis between the proximal jejunum and the distal ileum. Approximate operative time: 90–120 minutes.
2–3 nights in hospital. Early mobilization within 24 hours. Clear-liquid diet started. Daily medical visits until discharge.
If you're from outside Cancún, additional days in the city before flying home. Hotel near the hospital is suggested, with WhatsApp follow-up and fluid/vital-sign monitoring.
Clear liquids → full liquids → puree → soft solids over approximately 6 weeks, accompanied by the team's clinical nutritionist.
In-person or virtual visits at month 1, 3, 6, and 12. Bariatric psychology support available. Direct WhatsApp with me whenever you have a question — regardless of the hour.
04 · Outcomes
Available data come primarily from case series. Data at 5+ years are still being built. Your real outcome we evaluate in consultation — and the conversation honestly includes the limits of the evidence.
%EWL reported in the originating publication (Santoro et al. Annals of Surgery 2012). Case series.
High type 2 diabetes remission rates reported in case series, but sample sizes are small and follow-up is limited.
Data beyond 5 years not yet robustly published. Investigational classification per Brown et al., IFSO Position Statement, Obesity Surgery 2022. ASMBS has not endorsed it as a primary standard procedure.
Sources: Santoro et al. (Annals of Surgery 2012, originating publication); Brown et al., Innovative Bariatric Procedures and Ethics in Bariatric Surgery: the IFSO Position Statement, Obesity Surgery 2022.
05 · Cost
Each case has a different risk profile, hospital choice, length of stay, and follow-up program. Publishing a single number would be dishonest — it would either undersell complex cases or overprice simple ones.
WhatsApp me your weight, height, and any medical conditions. I respond within 24 hours with a real quote, hospital recommendation, and financing options if you need them.
06 · Bipartition vs Bypass
07 · Frequently asked
Next step
WhatsApp me your weight, height, and any medical conditions. I respond personally with a realistic evaluation — including whether bipartition is appropriate for your case, or whether an option with more evidence suits you better.
Reply within 1 hour · 24/7