Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S)
The Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S) is also known as a One Anastomosis Duodenal Switch (OADS). This is a recent (2007) procedure that modifies and combines both “Bileopancreatic Diversion (BPD) (an old established operation 1979)” with a “Duodenal Switch (DS) (established in 1986).
SADI-S (2007) essentially simplifies the “two” anastomosis (performed in BPD and DS) into “one”. This join is in a form of a “loop”. This procedure joins the duodenum (just passed the stomach) to the loop of ileum, which is about 200cm from the origins of the large bowel. This creates a significant malabsorption.
Advantages of SADI-S
One anastomosis (join)
Preserved pylorus and therefore less gut function disturbance (theoractical)
Good weight loss maintained
A good option for revision of other operation types
Disadvantages of SADI-S
Probable higher risk compared to gastric bypass- bleeding, nausea, anastomotic leaks
Malabsorption of fat soluble vitamins, micronutrients, iron, calcium and protein
Frequent bowel movements, flatulance and fatty stools
Mandatory requirement for multivitamin supplementation and testing for metabolic deficiencies
Lacking robust data (follow up and long term data).
Position statement by IFSO 2018
Currently considered as an “Investigational” procedure and NOT a recognised “Main-stream” procedure.
The procedure is considered “safe” and “efficacious” in the current form (SADI-S0.
Current concerns of insufficient long term data on nutritional issues.
Insufficient prospective or comparative data compared to the standard Bileopancreatic diversion or Duodenal Switch