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Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S)

SADI by Alex Gandsas, MD - Annapolis, Maryland

The Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy, also known as SADI-S, is the most recent procedure endorsed by the American Society for Metabolic and Bariatric Surgery. 

One of the main indications for SADI-S is as a revisional procedure for those patients with weight regain or insufficient weight loss after a Sleeve Gastrectomy.

Some studies have shown better weight loss with SADI-S when compared to Gastric Bypass to overcome weight regain after failed Sleeve Gastrectomy.

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The procedure entails:

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  1. Creation of a Sleeve Gastrectomy

  2. Dividing the Small bowel 2-3 cm beyond the stomach (divided duodenum)

  3. Bring a distal loop of bowel and connect it to the divided duodenum

Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy

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When the patient eats, food goes through the pouch and directly into the latter portion of the small intestine. The food then mixes with digestive juices from the first part of the small intestine.

This allows enough absorption of vitamins and minerals to maintain healthy levels of nutrition. This surgery offers good weight loss along with less hunger, more fullness, blood sugar control and diabetes improvement. 

Research has demonstrated that the SADI-S technique is effective not only effective in achieving a good initial weight loss but also in long term weigh maintance with low nutritional complications. 

One of the main advantages when compared to the Gastric Bypass or the Duodenal Switch is that the SADI-S involves only one connection between the small bowel, significantly decreasing potential post operative complications such as bowel obstruction and ulcers 

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