Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy

The Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy, referred to as the SADI-S, is the most recent procedure endorsed by the American Society for Metabolic and Bariatric Surgery. While similar to the BPD-DS, the SADI-S is simpler and takes less time to perform as there is only one surgical bowel connection.

The Procedure

The operation starts like the sleeve gastrectomy, making a smaller tube-shaped stomach. The first part of the small intestine is divided just after the stomach. A loop of the intestine is measured several feet from its end and is then connected to the stomach. This is the only intestinal connection performed in this procedure.

How it Works

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 nutrition levels. This surgery offers good weight loss, less hunger, more fullness, blood sugar control, and diabetes improvement.

Advantages

• Highly effective for long-term weight loss and remission of type 2 diabetes
• Simpler and faster to perform (one intestinal connection) than gastric bypass or BPD-DS
• This is an excellent option for a patient who already had a sleeve gastrectomy and is seeking further weight loss

Disadvantages

• Vitamins and minerals are not absorbed as well as in the sleeve gastrectomy or gastric band
• Newer operation with only short-term outcome data
• Potential to worsen or develop new-onset reflux
• Risk of looser and more frequent bowel movements

Education

You will receive information about sleeve gastrectomy during your initial consultation.

Review an animation video of the SADI to understand the procedure better.

The photo was reprinted with permission from the American Society for Metabolic and Bariatric Surgery, copyright 2024, and all rights reserved.