Single Anastomosis Duodeno-ileal Bypass with Sleeve (SADI-S): What is it?

Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy, or SADI-S, is a bariatric procedure to help you lose weight if you’re affected by severe obesity.

Obesity is a disorder that has been affecting an increasing number of people worldwide. Among the obesity-related diseases are type II diabetes, high blood pressure, sleep apnoea syndrome, as well as orthopaedic problems such as joint strain, back pain, or gout.

Being obese can affect your health and overall well-being deeply. Thanks to the latest medical advancements, there are ways to tackle this disorder and take back control of your life. When dieting or exercise has not proved to be enough to lose excess fat, surgery might be an option.

Weight-loss surgery, also known as bariatric surgery, comprises a series of procedures that aim to help you lose weight effectively. These procedures can be surgical, non-surgical, or more or less invasive. They all share the same goal: intervening on your digestive system to either limit food intake or reduce its absorption capacity.

These procedures include: sleeve gastrectomy (gastric sleeve), gastric bypass, endoscopic sleeve gastroplasty, and gastric balloon.

We recommend to each patient what procedure we believe will yield the best possible outcomes in their specific case. We do so by conducting a thorough initial assessment of their medical record, including questions about their current lifestyle, any current medical condition, or expectations they might have.

If you’re interested to know more about weight-loss surgery, contact us anytime! One of our patient coordinators will be in touch with you for a first consultation.

Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy: How does it work?

Other than the procedures listed previously, there is one weight-loss procedure that is becoming increasingly popular: Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy, or SADI-S.

This procedure is performed with a laparoscope and is basically a variant of duodenal switch surgery. It can be more effective because it combines a gastric bypass with a gastric sleeve. Below is a brief overview of how SAID-S works.

SADI-S is carried out under general anaesthesia. This means that you will be asleep during the whole duration of the procedure. It fundamentally involves two steps:

1. Sleeve gastrectomy: The surgeon will first remove around two thirds of your stomach and leave a banana-shaped pouch. By making your stomach smaller, you will feel full sooner and food intake will drastically reduce.
2. Gastric bypass: The surgeon will then detach the intestine just below the stomach and reattach it about 2 metres down. This means that this new structure ‘bypasses’ the section of the bowel that absorbs most of the nutrients and calories. For this reason, you will have to take supplements and vitamins long term.

One of the biggest benefits of SADI-S is that, contrary to duodenal switch surgery, only a single surgical anastomosis (or duodeno-ileal bypass) is made, making surgery less lengthy and therefore less risky. Moreover, having only one new intestinal connection prevents the risk of contents leaking from the intestine into the body cavity as well as the possibility of future bowel obstruction (i.e. internal hernia).

How to plan and prepare for SADI-S surgery

Once your SADI-S procedure is confirmed, we will send you detailed information on how to prepare for surgery. Pre-op recommendations are very similar for all weight-loss surgeries and it’s of paramount importance that you follow them closely. Your journey towards planning an SADI-S surgery might look like this:

1. Consultation

Firstly, we’d like to talk to you to understand your current health status, what your expectations are, and how KCM can help you. You will speak with one of our coordinators who will also be happy to answer any questions you might have. They will confirm if you’re eligible for the treatment and will provide you with pre-op guidelines for you to prepare for the procedure.

2. Pre-op diet

Diet guidelines before a Single Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy  include high-protein and low-carb foods. Around 5 to 7 days before the procedure, you will have to stay on a liquid diet to keep your stomach light. You should not drink any alcohol or sodas during this time. Also be mindful about sipping water very slowly. The night before the procedure patients are advised to fasten completely.

3. Gastroscopy

A gastroscopy is a medical test that might be required to assess whether your stomach is ready for the procedure. It examines your oesophagus, stomach, and the first part of your small intestine (small bowel). It is performed using an endoscope that will allow the doctor to look inside your ‘food pipe’ with the help of a small camera.

What is Sadi-s Diet 

The SADI-S diet is a modified version of the duodenal switch (DS) bariatric surgery that is less invasive and has a shorter recovery time. This diet consists of three distinct phases, each serving a specific purpose:

Phase 1: This initial phase spans over a period of 2 weeks and focuses on weight loss and liver reduction to ensure a safer surgery. During this phase, a liquid diet rich in protein and low in carbohydrates and fat is followed. Additionally, supplements are taken to ensure adequate nutrient intake.

Phase 2: The second phase, lasting for 4 weeks, is dedicated to helping individuals adapt to their new stomach and intestines. Gradually, solid foods are introduced into the diet while maintaining a high-protein intake and avoiding foods high in carbohydrates and fat.

Phase 3: The final phase, known as the maintenance phase, involves continuing a healthy diet that is high in protein and low in carbohydrates and fat. It is crucial to monitor weight and make necessary adjustments to the diet during this phase.

It is important to note that the SADI-S diet is a restrictive diet that may pose challenges in adherence. Therefore, it is strongly advised to consult with a doctor or registered dietitian before embarking on this diet to ensure its suitability for individual circumstances.

The SADI-S diet offers numerous benefits, including sustainable weight loss and weight management. By following this diet, individuals can reduce their risk of developing obesity-related health conditions such as type 2 diabetes, heart disease, and stroke. Moreover, it has the potential to enhance overall quality of life.

However, it is essential to be aware of the potential risks associated with the SADI-S diet. Adherence to this diet can be demanding, and there is a possibility of nutrient deficiencies. Additionally, side effects like nausea, vomiting, and diarrhea may occur. Furthermore, the risk of gallstones may increase.

Weight-loss surgery involves a lifelong commitment

Having weight-loss surgery can be lifesaving for many people. It’s often considered a ‘last resort’ when no meal plan or exercise routine has proved helpful or when related comorbidities or illnesses are severely affecting the health of the patient. However, it’s important to consider that bariatric surgery is only a piece of a bigger puzzle.

When you’re choosing to undergo a weight-loss procedure, it is important for you to be fully aware that surgery is the beginning of your new life. This can be thrilling and challenging at the same time, but for sure it’s a step towards the right direction – one that will make you healthier and happier.

Right after any weight-loss procedure, including SADI-S, our team of experienced doctors and nurses will provide you with a diet and exercise plan that you’re strongly advised to follow. You will start with light exercise and ramp up to cardio or more intense workouts as time goes by. You will feel stronger, fitter, and healthier.

We will be in touch with you for a few years after the surgery to keep tabs on your health and well-being. You will also have the possibility to join our Facebook support group for KCM’s bariatric patients – a valuable source of information, stories, and recommendations.

If you want to receive more information or know more about weight-loss surgery at KCM Clinic, get in touch with us here.