SADI Surgery

SADI is a weight loss surgery for severe obesity (class III obesity). It’s a modified version of the duodenal switch. It begins with a sleeve gastrectomy. This creates a smaller, tube-shaped stomach. Then, the first part of your small intestine (duodenum) is connected to a lower part of your intestine. This change leads to absorbing fewer calories.

SADI stands for single anastomosis duodenal-ileostomy. It also goes by these names:

• Single anastomosis duodeno-ileal bypass with sleeve (SADI-S)
• Single anastomosis duodenal switch

This procedure can lead to significant weight loss. It can also improve health conditions like Type 2 diabetes. After surgery, you’ll need to take vitamins for the rest of your life and have regular checkups with your provider. This ensures you get the nutrition you need to stay healthy.

How does SADI work?

SADI helps with weight loss in two main ways:

• Creating a smaller stomach: This part of the surgery makes your stomach long and narrow, so you feel full sooner and eat less. It also affects hunger hormones.
• Changing the pathway food takes: Your duodenum (the first part of your small intestine) is divided just after the bottom valve of your stomach. It gets reconnected to a lower part of your small intestine (ileum). This means the food you eat skips a large section of your small intestine.

Together, these changes lead to weight loss. That’s because you eat less and absorb fewer calories as food moves through your intestines faster.

There are many types of bariatric weight loss surgeries. All of them work differently. Your healthcare team can walk you through each type and help you decide which may work best for you.

How should I prepare for SADI?

Your provider will order tests to check your overall health. You may meet with a dietitian to learn about how your diet will change and what nutritional supplements you’ll need. They may recommend you follow a low-calorie or liquid diet before surgery.

Your provider will give you specific instructions to follow in the weeks or days leading up to surgery. They may ask you to stop smoking, avoid alcohol and change or reduce certain medications.

What happens during SADI?

The steps in the procedure generally go like this:

1. You get general anesthesia that puts you to sleep.
2. Your surgeon makes several tiny cuts in your belly. This is where they insert their surgical tools.
3. They remove part of your stomach to make it smaller and narrower.
4. They separate the first part of your small intestine (duodenum) just after your stomach.
5. Your surgeon finds a spot further down your small intestine to connect your stomach to.
6. They connect your duodenum to your lower small intestine using one “loop” connection point.
7. They remove the surgical tools. They then close the small cuts in your belly with stitches.

How long does SADI surgery take?

You can expect it to take around two hours. Your surgeon can let you know exactly what to expect.

What are the benefits and risks of SADI surgery?

The main benefit is that it leads to weight loss. It creates a smaller stomach, which means you eat less. It leads to less calorie absorption because food bypasses a larger section of your intestine. Other benefits are:

• Quicker and simpler surgery compared to the duodenal switch
• Improves obesity-related conditions like Type 2 diabetes, high blood pressure and sleep apnea
• Significant weight loss of around 73% of excess weight after five years

Some of the risks of SADI are:

• Greater risk of vitamin/mineral deficiencies due to more malabsorption (compared to the traditional gastric bypass and the sleeve gastrectomy)
• You must take nutritional supplements and follow up with your provider regularly
• Increased risk of frequent, loose bowel movements and passing gas

SADI is a newer bariatric procedure, so long-term data is limited.

What happens after this procedure?

You’ll have to spend one day in the hospital for monitoring after SADI surgery. In the first few weeks, you may notice changes in your bowel habits. You may also feel less hungry and have a lower appetite. Most people slowly return to normal activities within one month.

Once you go home, you’ll need to follow a special diet. This usually includes a full liquid diet for a few weeks before moving on to soft foods. You’ll gradually return to eating regular foods in small portions. This process can take up to three months. A dietitian will help you create a long-term eating plan that works for your health goals after surgery.

One of the most important parts of your long-term care is getting the nutrients you need. Surgery changes how your body absorbs vitamins and minerals. So, taking supplements is a key part of staying healthy. Your provider will schedule regular follow-up appointments to check for nutrient deficiencies. You can expect to do this for the rest of your life.

When should I call my healthcare provider?

Call your healthcare provider if you have any of the following after surgery:

• Severe abdominal pain
• Severe diarrhea
• Signs of dehydration, like peeing less, dry mouth and headache
• Fever
• Vomiting that doesn’t stop