Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S)

What is Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S)

A portion of the stomach is removed & the intestines length shortened.
The stomach is reduced by removing a portion of it, which reduces caloric intake.
Then the duodenum (1st part of intestine) is connected to the ileum (last part of intestine). This is to reduce the surface for food absorption.

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Pre Procedure

Laparoscopic Single Anastomosis Duodenal-Ileal Bypass with Sleeve (SADI-S) Eligibility

Laparoscopic Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S) is recommended for individuals who meet certain criteria. These may include:

Body Mass Index (BMI) of 40 or higher, indicating Morbid obesity (class III)
BMI of 40 or higher, accompanied by obesity-related health conditions such as diabetes, high blood pressure, sleep apnea, heart disease, cholesterol, etc.
Previous unsuccessful attempts at weight loss through diet, exercise, and other non-surgical methods
Past medical and surgical history may also affect eligibility, so it is important to come in for a consult beforehand.

MEDICAL - Obesity-related illnesses such as heart disease, stroke, type 2 diabetes, cholesterol, infertility, sleep apneas, asthma and cancer; are reduced. It also helps in long-term control of type 2 diabetes, and less dependence on medication — or the elimination of medication altogether.

PHYSIOLOGICAL - You may also enjoy the elimination of back and joint pain, decreased depression, improved breathing and increased energy.

PSYCHOLOGICAL - Dramatic improvements in your overall health and quality of life with improved self-image, increased self-confidence and the satisfaction that comes from enjoying a wider range of activities with friends and loved ones. Results may vary dependent on lifestyle changes as well, we recommend an amalgamated approach for best results and sustainability.

WEEKS BEFORE
To determine the suitability & your body’s fitness for the surgery we will take you through medical, psychological, nutritional assessments and pre-counselling.
The pre-surgery weight loss diet is essential because it is low in fat and carbohydrate content, helping reduce your glycogen levels and reduce your liver size so that the operation can be conducted.
There should be no intake of caffeinated drinks (coffee and energy drinks) at least a week before your surgery date. Your dietary intake in the week leading up to the surgery should be light, like vegetables and fruits.

DAYS BEFORE
You'll need to stop smoking, eating heavy unhealthy meals, stop taking aspirin, ibuprofen, and other blood-thinning medicines in the days before your surgery. You shouldn't eat or drink anything after midnight before surgery.

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Post Procedure

Recovery may vary from person to person, but here’s what you need to know:
Hospital Stay: 2-3 days after the surgery to ensure proper healing, rehabilitation, and monitoring of progress. Patients who have undergone laparoscopic procedures may return to work within 1 week after surgery. However, it is not advisable to engage in intense physical work.

Shortly after surgery, you'll begin reintroducing foods into your diet in phases in consult with your nutritionist who will teach you how and what to eat with your reduced stomach size. You'll start consuming a clear liquid diet within 24 hours of your surgery, then advance to a full liquid diet, a soft food diet, and your regular diet in the weeks ahead. You will also have to reduce certain foods, such as simple sugars, including honey, white sugar, or syrups, to avoid dumping syndrome. You will need to chew slowly and fully, and not to drink 30 minutes before or after you eat. While it may seem demanding, ignoring dietary recommendations may cause constipation, dehydration, diarrhea, or in extreme very rare cases, gastric acid leakage.

You will have follow-up visits with your bariatric surgery team to help you develop good eating and exercise habits that will change your lifestyle. Your initial weight-loss may occur quickly, so it's important to get all of the nutrition and vitamins you need as you recover. To prevent nutritional problems after surgery, your doctor may advise on supplements like Vitamin B12 and iron.

Tell your doctor right away if you have any of the below:

Fever
Your wound becomes painful or hot to the touch or leaks fluid
Coughing or trouble breathing
Vomiting and diarrhea
Pain in the abdomen, chest, shoulder, or legs
Any other problems or symptoms

During weight-loss, you may have body aches, dry skin, mood changes, and temporary hair thinning, and feel tired and cold among others. As your weight stabilizes, these problems should go away. Weight loss continues for about a year, and then it will stabilize at your body’s optimum BMI. It is important to incorporate lifestyle modification for sustainability and lifelong results.

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How Is It Done & How Does It Work

Done laparoscopically under anesthesia in about 2-3 hours. The stomach is reduced by removing a portion of it. Then the middle part of the small bowel is excluded from food transit by connecting the last part of the small bowel (ileum) to the 1st part of the small bowel (duodenum). In summary, the food travels from the small new stomach to the distal intestine bypassing a long segment of the small bowel, which remains in the abdominal cavity, but is excluded from the food circulation. This reduces the food intake as well as absorption causing significant weight loss. Usually for BMIs over 40, with up to 70% excess weight reduction. Involves 3 components:

Sleeve gastrectomy (restrictive component)
Shortening the intestines food path (malabsorption component)

Laparoscopic surgery done using tiny incisions in the abdomen, under anesthesia and usually lasts about 3 hours with about 2 days as hospital stay. Weight loss occurs gradually being fastest in the first months. 1.5-2 years may be required for maximum weight loss.

Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S) VS GASTRIC BYPASS

The Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S) is best performed on patients with a BMI greater than 40.

Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S) is one of the most powerful options for patients with severe obesity, either as primary surgery or as a revisional procedure after failure of a sleeve gastrectomy. The anatomical changes decrease oral intake and reduce the absorption of the nutrients and calories eaten.

In this light, it is important to keep in mind risks like gall stones, bowel habit changes, excessive loose skin, and malnutrition, that are more likely in the Gastric Bypass (RYGB) than in Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S). Lifestyle changes after Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S) such as eating habits should be adapted well to prevent side effects.

It has less likelihood of weight regain relapse & achieves more weight loss compared to other bariatric procedures.

The process to get you started on your weight loss journey

Non - Surgical Approaches

Achieving and maintaining a healthy weight is essential for overall well-being.

While weight loss journeys vary from person to person, there are numerous safe and effective methods available, both surgical and nonsurgical.

Here, we explore different approaches to healthy weight loss.

Surgical Weight Loss

Gastric Sleeve

Gastric sleeve surgery, or sleeve gastrectomy, is a widely favoured, minimally invasive weight loss solution. Removing a significant part of the stomach forms a smaller, banana-shaped stomach, curbing food intake, aiding weight loss, and enhancing health in cases of moderate to severe obesity.

Gastric Bypass

Gastric bypass, a proven weight loss approach, forms a small stomach pouch and redirects the small intestine. While more invasive than the gastric sleeve, it effectively induces weight loss and improves health conditions, demanding rigorous post-surgery dietary adherence for optimal outcomes.

Mini Gastric Bypass

The mini gastric bypass streamlines the traditional process, establishing a smaller stomach pouch directly linked to the small intestine. Balancing effectiveness and invasiveness, it delivers substantial weight loss and health benefits, demanding lifelong dietary adherence for success, making it a preferred choice.

Duodenal Switch

The duodenal switch, a preferred weight loss surgery for severe obesity, involves stomach reduction and small intestine rearrangement to limit calorie absorption, leading to significant weight loss. Despite its effectiveness, careful dietary management is crucial, making it suitable for those unsuccessful with other treatments.

FAQs

Obesity surgeries are evaluated based on body mass index, previous surgeries, previous medical history, amount of weight loss desired as well as financial implication – are the variables that help determine this.

It is dependent on an individual’s body mass index (BMI) and the presence of any co-morbidities. You may qualify for surgery if you have a BMI of 40 or greater, or if your BMI is at least 35 with other obesity-related health problems e.g. diabetes, heart disease, hypertension, and sleep apnea.

Usually 1-4 days of stay in the hospital. Problems that may occur during the preoperative evaluation and postoperative recovery period may determine this period.

Communication with your team and following your doctor’s instructions can prevent majority of the complications. Some include – dumping syndrome, dehydration, and nutrient deficiencies but can be avoided if the correct diet is followed and supplements.

We will transition you from liquid diet to solid diet gradually. High carb, sugary fluids and generally junk meals are to be reduced or completely avoided for better results, minimal side effects and sustainability of weight loss

After leaving the hospital, heavy activities should be reduced. The patient should not lift heavy loads for about 6 weeks.