A Prospective, Multi-center, Single-arm Study of the Stomach, Intestinal and Pylorus Sparing (SIPS) Procedure

SIPS is a single-anastomosis duodeno-intestinal switch procedure. Preliminary data from
Sanchez-Pernaute et al. (Surg Obes Relat Dis 2013;9:731) indicates that this procedure is
safe, quick to perform, and offers good results for treatment of both morbid obesity and its
metabolic comorbidities. CovidienTM plans to further investigate this procedure and has
proposed a prospective clinical study to obtain data on subject outcomes through 12 months
following the SIPS procedure.

Inclusion Criteria:

- The subject must be 18-65 years of age

- The subject must be willing and able to participate in the study procedures and to
understand and sign the informed consent

- The subject is under consideration for surgery for obesity or metabolic disease and
elects to undergo a primary SIPS procedure

- The subject has a BMI of 35-40 kg/m2 with at least 1 obesity-related comorbidity or a
BMI of 40-60 kg/m2

Exclusion Criteria:

- Any female subject who is pregnant, or is actively breast-feeding

- Any subject who is considered to be part of a vulnerable population (e.g. prisoners
or those with psychological concerns or those without sufficient mental capacity)

- The procedure is an emergency procedure

- The procedure is a revision/reoperation for the same indication

- The subject is unable or unwilling to comply with the study requirements or follow-up
schedule

- The subject has conditions which, in the opinion of the investigator, will not be
appropriate for the study (e.g. severe cardiovascular disease, history of
gastrointestinal (GI) malignancy, history of upper GI surgery, open cholecystectomy,
history of intestinal surgery, immunosuppression, or non-ambulatory)

- The subject has an estimated life expectancy of less than 6 months

- The subject has participated in an investigational drug or device research study
within 30 days of enrollment