SADI Surgery

Also Known as Loop Duodenal Switch, Loop DS Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S)

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Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy (SADI-S) is a relatively new procedure that starts with a sleeve gastrectomy and requires only one bowel connection rather than the traditional two performed during a duodenal switch. Duke weight loss surgeons have been performing the loop duodenal switch successfully for more than five years. It is a simpler operation than the traditional duodenal switch, has lower complication rates, improves obesity-related conditions, and results in good weight loss outcomes.

Attend a Free Information Session Online

Learn more about obesity and weight loss surgery at one of our free information sessions.

What Is 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.
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SADI Surgery Advantages

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.

Our Locations

Attend your pre-surgical evaluation, doctor appointments, and monthly support meetings near where you work or live. Attend a free information session online to learn more about obesity and weight loss surgery.

SADI Surgery Complications/Disadvantages

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.

Take the Next Step

Fill out our application if you are interested in starting the weight loss surgery process. Once your application has been submitted, we will call you to schedule your first appointment.

A badge from the American College of Surgeons and American Society for Metabolic and Bariatric Surgery for an Accredited Center Quality Program
Bariatric Center of Excellence

Duke Regional Hospital is accredited by the American Society for Metabolic and Bariatric Surgery for its high standards of care in weight loss surgery. 

This page was medically reviewed on 11/17/2023 by