SADI-S Surgery
Single Anastomosis Duodeno-Ileostomy with Sleeve
The most innovative bariatric procedure available — delivering results nearly identical to the traditional duodenal switch, with one intestinal connection instead of two, lower complication risk, and fewer nutritional side effects.
What Makes SADI-S Different
SADI-S is essentially an evolved version of the duodenal switch — it starts with a sleeve gastrectomy (reducing the stomach by ~80%) and then adds an intestinal bypass. The critical difference: SADI-S uses only one intestinal connection (anastomosis) instead of the two required in traditional DS.
That single connection is made 250–300 cm from the end of the small intestine — significantly longer than the DS (~100 cm). This longer common channel means better nutrient absorption and fewer nutritional deficiencies while still achieving outstanding weight loss and metabolic results.
The pyloric valve — which controls how fast food leaves the stomach — is preserved in SADI-S, significantly reducing the risk of dumping syndrome compared to gastric bypass.
SADI-S is also an excellent option for gastric sleeve patients who have experienced weight regain — it can be performed as a revision to the sleeve, converting it to a much more powerful metabolic procedure.
One connection = lower leak and complication risk
Each bowel connection is a potential leak site. One anastomosis instead of two meaningfully reduces that risk.
Pylorus preserved — less dumping syndrome
Preserving the pyloric valve allows better control of food leaving the stomach — reducing dumping syndrome significantly compared to bypass.
~90% Type 2 diabetes remission
Nearly as effective as traditional DS for diabetes resolution — and significantly better than sleeve or bypass alone.
Ideal for sleeve gastrectomy revision
Patients who had a sleeve and experienced weight regain are excellent SADI-S candidates — it converts the sleeve into a much more powerful procedure.
What Every SADI-S Patient Should Know
Many insurers still consider SADI-S experimental
Although endorsed by ASMBS in 2020, many insurance companies still classify SADI-S as experimental and may not cover it. This is changing rapidly. Our team will verify your coverage and explore all options with you. Self-pay pricing is available.
Lifelong vitamin supplements required
Like the traditional DS, SADI-S requires lifelong daily supplements — though the longer common channel means lower nutritional risk than DS. Multivitamin, fat-soluble vitamins (A, D, E, K), protein, and calcium monitoring are all important.
Shorter long-term outcome data than DS or bypass
SADI-S is newer than bypass or traditional DS, so very long-term (15+ year) data is still accumulating. Current outcomes data up to 8–10 years is excellent and consistent with DS results.
Shorter operating time than traditional DS
One connection instead of two means the surgery is technically simpler, faster, and carries lower intraoperative risk. This is a meaningful advantage for high-BMI patients who face elevated surgical risk.
Can be done in one or two stages
Like the traditional DS, SADI-S can be performed in two stages for very high-BMI patients — sleeve first, then the intestinal bypass after initial weight loss reduces surgical risk.
Bowel habits improve over time
Similar to the DS, early post-op bowel changes are common. Most patients see improvement within 6–12 months as the body adapts to the new digestive anatomy.
Is SADI-S the Right Procedure for You?
Whether you're a first-time surgery patient or looking to revise a prior sleeve, our surgeons will evaluate your case and help you decide if SADI-S is your best option.