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SADI-S

What is a Sleeve with Duodenal Bypass

The Single-Anastomosis Duodeno-Ileal Bypass with Sleeve (SADI-S) is a modern evolution of the biliopancreatic diversion. It maintains the strong metabolic effect of the original operation while minimizing long-term nutritional issues.

Who are suitable candidates?

  • BMI ≥ 40, or severe obesity with associated health problems.
  • Type 2 diabetes, high cholesterol, or metabolic syndrome.
  • Suboptimal weight loss or recurrent weigh gain after sleeve gastrectomy.

Advantages

  • Marked and durable weight loss: Typically 30–35% TWL.
  • Powerful metabolic benefits: Improves or completely resolves type 2 diabetes in 60–80% of cases.
  • Hormonal appetite control: Early stimulation of GLP-1 and PYY suppresses hunger.
  • Improvement of obesity-related diseases: Hypertension, sleep apnea, dyslipidemia, fatty liver, joint pain.
  • Laparoscopic approach: Enables faster recovery.
  • Reduced but not eliminated deficiency risk: Requires lifelong supplementation and monitoring.
  • Improved quality of life: Better mobility, mood, and self-image.

The Procedure

  • Surgery duration: 60–120 min
  • Hospital stay: 2–3 days
  • Recovery time: ≈ 2 weeks
  • Expected weight loss: 30–35% TWL
  • Major complication rate: ~1–2% | Mortality: 0.1–0.3%
  • Lifelong follow-up: Vitamin and mineral replacement mandatory.