(SADI)
Single Anastomosis Duodenal Switch
Transform yourself with
"*" indicates required fields
By submitting this form you agree to receive emails, calls, and text messages from BodEvolve related to our services. This agreement is not a condition to purchase and you can opt-out at any time.
Overview
What is SADI surgery?
Single Anastomosis Duodenal Switch (SADI), also known as SADI-S or Loop Duodenal Switch, is an advanced bariatric procedure designed to promote significant weight loss while improving metabolic health. This surgery combines restriction (reducing stomach size) with malabsorption (limiting calorie absorption in the intestines) to enhance long-term weight loss outcomes.
Unlike traditional duodenal switch (DS) surgery, SADI involves a single intestinal connection (anastomosis) instead of two, making it a simpler and safer alternative with similar benefits. This procedure is particularly effective for individuals with severe obesity (BMI over 50) or those seeking additional weight loss after gastric sleeve surgery.
How does SADI surgery promote weight loss?
SADI surgery facilitates weight loss through two primary mechanisms:
- Restriction – The procedure includes a sleeve gastrectomy, which reduces stomach capacity and limits food intake.
- Malabsorption – A portion of the small intestine is rerouted, decreasing the absorption of calories and fat while maintaining nutrient absorption.
This dual mechanism enhances weight loss while helping regulate blood sugar and appetite hormones.
How common is SADI surgery?
SADI is a newer variation of the duodenal switch that has gained popularity among bariatric surgeons due to its lower risk of complications compared to traditional DS surgery. While not as commonly performed as gastric sleeve or gastric bypass, SADI is becoming an increasingly preferred option for patients with higher BMIs or those requiring weight loss revision surgery.
What medical conditions can SADI help treat?
In addition to promoting substantial weight loss, SADI can significantly improve or resolve many obesity-related conditions, including:
- Type 2 diabetes and insulin resistance
- High blood pressure (hypertension)
- High cholesterol and metabolic syndrome
- Sleep apnea and obesity-related breathing disorders
- Joint pain and osteoarthritis
Is SADI surgery safe?
SADI is considered safer than the traditional duodenal switch due to its single anastomosis, which reduces the risk of complications such as intestinal leakage and obstruction. While it involves a degree of malabsorption, the risk of severe nutritional deficiencies is lower compared to standard duodenal switch surgery.
Procedure Details
Who qualifies for SADI surgery?
Candidates for SADI surgery typically include individuals who:
- Have a BMI of 50 or higher or a BMI of 40+ with obesity-related conditions
- Have struggled with significant weight regain after gastric sleeve surgery
- Require more weight loss than gastric bypass can provide
- Are committed to long-term dietary and lifestyle changes
Since SADI involves some degree of nutrient malabsorption, candidates must be willing to follow strict post-surgical nutritional guidelines to maintain proper vitamin and mineral levels.
What happens before SADI surgery?
Prior to surgery, patients are placed on a pre-operative liquid diet for 1–2 weeks to reduce liver size and improve surgical outcomes. A comprehensive medical evaluation is conducted, including:
- Nutritional counseling
- Psychological assessment
- Bloodwork and pre-surgical screening
Patients must also fast for at least 12 hours before surgery to prevent complications during anesthesia.
How is SADI surgery performed?
SADI is typically performed laparoscopically using minimally invasive techniques to reduce recovery time and post-operative discomfort. The surgery consists of two main components:
- Sleeve Gastrectomy – The stomach is reduced by 80%, leaving a narrow, tube-like structure.
- Small Intestine Rerouting – The duodenum (upper part of the small intestine) is connected to a section of the lower intestine, bypassing part of the digestive tract to limit calorie absorption.
Unlike the traditional duodenal switch, only one intestinal connection (anastomosis) is created, lowering the risk of complications.
The procedure takes approximately 90 to 120 minutes, with most patients staying in the hospital for one to two days for monitoring.
What happens after SADI surgery?
Following surgery, patients begin a liquid diet, gradually transitioning to soft foods before reintroducing solids over several weeks. Regular follow-ups with a bariatric team are essential to monitor weight loss progress, nutritional status, and any potential complications.
Risks / Benefits
What are the advantages of SADI surgery?
SADI provides substantial weight loss and metabolic benefits, making it a highly effective option for patients with severe obesity. Advantages include:
- Greater weight loss potential than gastric sleeve or gastric bypass
- Improved blood sugar control, often leading to diabetes remission
- Lower risk of nutritional deficiencies compared to standard duodenal switch surgery
Simpler surgical technique with a single intestinal rerouting, reducing complications
What are the possible risks or complications?
While SADI is generally safe, potential risks include:
- Vitamin and mineral deficiencies, requiring lifelong supplementation
- Gastroesophageal reflux (GERD), which may worsen after surgery
- Loose stools and increased bowel movements due to fat malabsorption
- Protein deficiency if dietary intake is insufficient
With proper medical supervision and adherence to post-operative dietary guidelines, most risks can be effectively managed.
Recovery and Outlook
How long does recovery take?
Most patients return to light activities within one to two weeks and resume normal routines within four to six weeks. Some fatigue is common as the body adjusts to lower calorie intake, but energy levels improve as patients adapt to their new lifestyle.
How much weight can be lost with SADI surgery?
Patients typically lose 60–80% of their excess body weight within 12 to 24 months. The most rapid weight loss occurs in the first six months, with continued progress for up to two years.
For example, a patient with 200 pounds of excess weight may expect to lose between 120 to 160 pounds over this period.
What if weight loss plateaus or weight is regained?
While weight regain is uncommon, it can occur due to:
- Poor dietary choices
- Inadequate protein intake
- Lack of adherence to lifestyle changes
Patients who struggle with weight maintenance may benefit from additional nutritional counseling, exercise plans, or revision surgery if necessary.
Final Thoughts on SADI Surgery
SADI is a powerful tool for significant weight loss and metabolic improvement, particularly for individuals with severe obesity or prior weight loss surgery failures. By combining restriction and malabsorption, this procedure helps patients achieve long-term success while maintaining better nutritional balance than traditional duodenal switch surgery.
At BodEvolve, our bariatric specialists provide comprehensive pre- and post-surgical care, ensuring each patient receives personalized guidance and long-term support.
For more information or to determine if SADI surgery is right for you, schedule a consultation today.