SADI-S: Newest Weight Loss Surgery Explained

If you are morbidly obese and have health problems like Type 2 diabetes or heart disease, there is a type of bariatric surgery that might be worth exploring.

 It’s called Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy, or SADI-S. 

What Is SADI-S?

A procedure called duodenal switch is a common choice for patients with both higher weight and Type 2 diabetes. That involves two surgical connections, though. The SADI-S is similar, except it entails only one connection. That’s between the first portion of your bowel, known as the duodenum, and another about 250 to 300 centimeters from your colon.

In practical terms, that means one less risk of things that can go wrong. It also reduces the chances of developing a bowel obstruction. SADI-S can be performed laparoscopically, meaning through a few small incisions, and robotically, using a specialized machine and small incisions.

In general, SADI-S patients lose 35 percent of their body fat within a year. What’s more, they keep the weight off. That’s due to three main reasons:

• You’ll have a smaller stomach. The surgeon will make your stomach smaller, about the size and shape of a banana. You’ll have room for less food, so you’ll need to eat less. This is the sleeve gastrectomy component, which can also be done on its on its own.
• You’ll be less hungry. Reducing both your stomach size and bowel leads to a decreased appetite. You’ll feel satiated mostly due to reductions in the hunger hormone ghrelin.
• Your blood sugar might level off. SADI-S increases the amount of glucagon-like peptide 1 (GLP1) your body will produce, along with other hormones. GLP1 affects both weight and blood sugar. For you, that means fewer blood-sugar issues.

Those are among the reasons the American Society of Metabolic and Bariatric Surgery approved SADI-S as an “appropriate metabolic procedure” in 2020.

Why Wouldn’t I Choose SADI-S?

Bariatric surgeons offer several types of weight-loss procedures because no one choice is best for all patients. Seek out honest answers to these questions before you commit to SADI-S.

• Is my body mass index 50 or higher? While anyone who qualifies for bariatric surgery can have SADI-S surgery, it is most beneficial for those with a BMI of 50 or more, or 45 If you have Type 2 diabetes or have had a sleeve gastrectomy.
• Will I really take vitamin-mineral supplements every day for life? SADI-S patients require extra vitamin A, D, K and E, plus some iron, zinc and calcium. If you’re not committed to a supplement regime, choose an option that allows your body to absorb nutrients from foods better. Otherwise, you  can get malnourished. 
• Will my insurance cover a SADI-S? Some companies do not yet approve paying for this procedure. Talk to your provider’s office and insurance to see if you have coverage.

Here’s one more reality-check question: Will you be willing to go to the bathroom more often? If you have SADI-S surgery, you’re likely to have more bowel movements daily than you currently do. In addition, SADI-S is the wrong choice if you have Crohn’s disease and certain other medical conditions.

On the positive side, you can also have SADI-S performed if you’ve already had a sleeve gastrectomy and want to lose more weight, assuming you haven’t developed an acid reflux problem.

It’s Worth a Look if Your BMI Is High

SADI-S is the hot topic of conversation among bariatric surgeons, in part because the procedure is such a good choice for patients with BMIs on the high end. The option has been around for more than a decade and was endorsed by the American Society for Metabolic and Bariatric Surgery in 2020. With a decade of research conducted and data collected, doctors are eager to see patients choose this option, when appropriate.

If you meet the criteria and have coverage, be sure to consider SADI-S as an option for your weight-loss surgery.