Sadi Anastomosis Duodeno-Ileostomy (SADI)
The Single Anastomosis Duodeno-Ileostomy, or SADI, is the most recent weight loss procedure to be endorsed by the American Society for Metabolic and Bariatric Surgery (ASMBS).
It is often referred to as a simpler version of the Biliary Pancreatic Diversion with Duodenal Switch procedure that includes only one bowel connection. The latter treatment has proven to be a very effective surgical weight loss option for many patients; however, the procedure is known for its complexity.
Watch this short video to see how the Single Anastomosis Duodenal Switch Procedure works. Video courtesy of Johnson & Johnson
Advantages
According to the ASMBS, some of the advantages & disadvantages of SADI include:
- Effective for long-term weight loss and improvement or resolutions of Type 2 Diabetes
- Faster and more simple to perform than gastric bypass or BPD-DS procedures.
- Excellent option for those who have previously had a sleeve gastrectomy and are seeking increased weight loss
Disadvantages
- Vitamins and mineral absorption is less than with the sleeve gastrectomy
- Newer procedure without long-term outcome data
- Can worsen or prompt the development of acid reflux
- Potential for looser and increased bowel movements
Dr. Williams explains the differences between the BPD/DS (Biliary Pancreatic Diversion with Duodenal Switch) and the SADI (Single Anaatomosis Duodeno-Ilesotmy procedures.
Procedure
There are two stages to this particular procedure: first, a sleeve gastrectomy will be performed, which will remove a significant portion of the stomach and reshape the remaining portion. After this stage, the duodenum is separated beyond the pylorus and the lower portion of the intestine (ileum) is anastomosed (connected) to the duodenum.
The main difference between SADI and other types of duodenal switch operations is that there is only one anastomosis as opposed to two. This allows nutrients to pass through one common loop, which may result in less fat soluble vitamin deficiencies and fewer possible side effects such as diarrhea.
The SADI procedure offers good weight loss as well as less hunger, increased fullness, blood sugar control and diabetes improvement or resolution.

Recovery
The SADI surgery typically takes only about an hour to complete and many patients often need to spend no more than one or two nights in the hospital. Most individuals are able to return to normal daily routines after approximately two to four weeks.
Many patients who undergo SADI procedure lose significant amounts of weight and reduce serious risks to their overall health.