SADI Surgery

Your surgeon will remove about 80% percent of the stomach  (this is the gastrectomy), leaving the remaining portion of the stomach shaped like a tube, or sleeve. Just below the opening of the stomach (this is called the pylorus) is the duodenum. This is the first part of the small intestine. Your surgeon will divide the small intestine and shape it into a loop that is connected to the stomach. This is the only intestinal connection in this procedure.

How Does SADI Surgery Work?

• The smaller, newly created stomach holds less food, which means fewer calories are ingested.
• More of the small intestine is bypassed which results in the digestion of less food.
• The altered food pathway changes the levels of gastrointestinal hormones that decrease hunger, increase fullness, enable the body to lose weight, and allow you to reach and maintain a healthy weight. This often results in the improvement of obesity-related conditions including diabetes.

Safe, Effective Weight Loss Surgery
Studies show that SADI surgery is safe and results in long-term weight loss. Excess weight loss and total weight loss were 87% and 38% at 5 years and 80% and 34% at 10 years. It effectively controls diabetes, promotes feelings of fullness, lowers high blood pressure and high cholesterol, and reduces sleep apnea problems.

Lower Risk of Ulcer and Bile Reflux
Because the small intestine is connected below the pylorus in the duodenum, there is a lower risk of a marginal ulcer when compared to Roux-en-Y gastric bypass or one anastomosis gastric bypass. This lower connection also prevents bile from coming back into the stomach, which decreases the risk of bile reflux.

Decreased Likelihood of Dumping Syndrome
Because the pylorus is preserved, there is a lower risk of dumping syndrome compared to other bariatric procedures.

Lower Risk of Leaks and Hernias
The single small intestine connection reduces the risk of leaks and internal hernias.

Less Risk of Diarrhea, Vitamin Deficiency, and Malnutrition
When food is ingested after surgery, it passes through the stomach, then directly into the latter portion of the small intestine. The food then mixes with digestive juices from the first part of the small intestine. This allows enough absorption of vitamins and minerals to maintain healthy levels of nutrition. Nutritional supplementation is still needed following this surgery.

Increased Risk of Bowel Concerns
There is an increased risk of looser, more frequent bowel movements, and foul-smelling gas, especially when eating food high in fat.

More Long-Term Data Needed
While published studies show the procedure remains effective long-term and has few complications, more data is needed.

Very Limited Insurance Coverage
Although the procedure was recently adopted as a standard bariatric surgery by the American Society for Metabolic and Bariatric Surgery, many insurance companies do not cover it. Blue Cross, Blue Shield of North Carolina do provide coverage.

More Technical Experience Required
Duke weight loss surgeons have been performing the procedure for five years. They have many years of experience altering the duodenum, which is an area of complex anatomy.