Single Anastomosis Duodenal-Ileal (+ Sleeve) Bypass(SADI-S)
Single Anastomosis Duodenal-Ileal (+ Sleeve) Bypass
What is the SADI-S?
The Single Anastomosis Duodeno-Ileal (+ Sleeve) Bypass (SADI-S), also known as Stomach Intestinal Pylorus-Sparing (SIPS) surgery, or One Anastomosis Duodenal Switch (OADS), is considered a less-aggressive variation of the older style duodenal switch procedure. It is a surgical weight loss operation that combines two procedures – a sleeve gastrectomy, and a duodeno-ileal (bowel) bypass. The SADI-S can be performed either robotically or laparoscopically (keyhole surgery), leaving you with about five small incisions (cuts) in your abdomen.
How does the SADI-S help you?
- This procedure combines both food restriction (due to the Sleeve Gastrectomy), and decreased calorie absorption (due to the Duodenal-Ileal Bypass).
- The combination of restricted food intake as well as less ability to absorb all that you eat, results in significant weight loss.
- Additionally, your satiety hormone LEPTIN will increase, and your hunger hormone GHRELIN will decrease, causing you to feel less hunger, and feel fuller for longer.
Advantages of the SADI-S
- Combine benefits of both the sleeve gastrectomy and the bypass
- Greater average weight loss than either sleeve gastrectomy or standard bypasses
- Has only one join, instead of two
- Greater metabolic effect than other procedures – rapid improvement of type 2 diabetes and other health conditions
- Usually less ‘dumping’ and diarrhoea than other bypasses as the pylorus valve is preserved
- Reduced risk of gastric ulcers
- Reduced risk of internal hernia developing
- Good weight loss maintenance
- Good option as a revision procedure
Disadvantages of the SADI-S
- More surgically complex than other weight-loss procedures
- Higher complication rates and risk for mortality than other procedures
- Increased risk of a leak due to two staples lines – one at the sleeve gastrectomy and the other at the bowel-to-bowel join
- May still experience ‘dumping’ if fats/sugars consumed.
- More frequent bowel movements, flatulence and fatty stools
- Greatest potential for malabsorption of vitamins and minerals – lifetime commitment to vitamin intake and annual blood tests is essential
- Newer operation than others – research data still emerging
- Not suitable for smokers
Risk and Complications of the SADI-S
Risks In the Short-Term
(common to most surgical procedures)
- Bleeding during or after the operation
- Damage to surrounding organs
- Wound infections
- Chest infections
- Deep Vein Thrombosis (blood clots in your legs)
- Pulmonary Emboli (blood clots in your lungs)
- Leakage or bleeding at the stomach staple line, or at the bowel-to-bowel join
- Death (very rare)
- Anaesthetic complications (see this section detailing these)
Risks In the Long-Term
- Potential for adhesions or scar tissue formation within the abdomen (can occur after any abdominal procedure) and may require surgery to release
- Potential for hernia formation at the site of the wound closure – this may require surgery to repair
- Potential for internal hernia/bowel obstruction, where loops of bowel tangle/twist – this may require surgery to correct
- Potential for anastomotic strictures where the bowel-to-bowel join over tightens during the healing process – this may require stretching by gastroscopy
- Potential to develop bile reflux – this may require medication or revision surgery
- Potential to develop ulcers if patients smoke
- Potential for development of nutritional deficiencies due to bowel involvement and malabsorptive feature of procedure – essential to maintain good diet + commit to vitamin/mineral supplementation + undergo annual blood tests to monitor/correct any deficiencies