Single Anastomosis Duodenal Switch (SADI): Everything You Need to Know

Single Anastomosis Duodenal Switch (SADI)

If you’re exploring weight loss surgery options, you must have come across SADI surgery, extensively known as Single Anastomosis Duodenal Switch. This procedure is a medically proven effective solution for individuals suffering from weight loss struggles. You want to lose fat and achieve your weight loss goals.

In this article, we will discuss SADI surgery in detail. We’ll explore its ins and outs, understand how it works, discuss the potential benefits of it, and whatnot. So let’s get into it.

What is SADI Surgery?

Singlе Anastomosis Duodеnal Switch (SADI) is a weight loss surgery designed for pеoplе suffering from sеvеrе obеsity, also known as class 3 obеsity. Typically, pеoplе with a BMI of 40 or more and at least 100 pounds of excess weight arе candidates for this procеdurе. Sеvеrе obеsity can lead to several health risks, including diabеtеs, high blood pressure, obstructivе slееp apnеa, and othеr lifе-thrеatеning conditions, which can shortеn lifе expectancy. For pеoplе with severe obesity, laparoscopic SADI surgеry may be the best option for long-lasting weight loss and lеss regain compared to other types of bariatric surgery.

How Does SADI Surgery Work?

This surgery simplifies the traditional duodenal switch by only bypassing 60-75% of the small intestine and creating just one connection instead of two. This procedure uses only 4 to 5 small incisions. Here’s how it works:

  1. Sleeve Gastrectomy: About 80% of the stomach is removed, leaving a banana tube-shaped, smaller stomach. This limits how much you can eat.
  2. Intestinal Bypass: Unlike the regular duodenal switch with two connections, SADI connects the end of the intestine directly to the duodenum near the stomach. This one-step process makes the surgery less complex, reduces the risk of bowel obstruction complications, and is equally safe.

After the SADI procedure, you’ll need to follow certain nutritional guidelines. Your bariatric team will provide specific instructions on how much protein and fluid you need. You’ll also need to take vitamins and supplements to prevent malnutrition. Lifelong follow-up care is required after SADI surgery.


All bariatric surgeons provide effective bariatric surgeries for excessive weight loss; however, SADI stands out in weight loss surgeries because of its reduced risk, simplified surgical procedure, shorter recovery time, and fewer nutritional deficiencies. It is an excellent alternative for effective weight loss because it is less invasive than traditional weight loss surgery.


Two weeks before your surgery, you’ll switch to a special diet. This helps reduce abdominal fat and shrink your liver, making the surgery more accessible and safer. The pre-op diet is high in protein but low in carbs, calories, and fat. Focus on easily digestible foods with few solids.

Post-surgery, your diet will be very restricted. Start with clear liquids for the first week, then include fruit drinks and non-fat milk in the second week. In the third and fourth weeks, pureed foods will be introduced. By weeks five and six, you can eat more variety in small amounts. Remember to avoid high-fat and junk foods to maintain your weight loss long-term.

Benefits of SADI Surgery

Anastomosis Duodenal Switch (SADI) not only helps individuals with their weight loss, but it is also really effective in managing conditions like type 2 diabetes. Apart from this, this procedure comes with many other advantages, such as:

  • Shorter stays in the hospital for about 2 to 3 days. And patients find it OK to return to their healthy activities after 2 weeks.
  • Individuals can lose 30-50% of total body weight as a result of SADI, and it also has significant long-term consequences.
  • Unlike gastric sleeve, complications like ‘dumping’ and gastric ulcers seem very uncommon with this surgery.
  • Bypassing food away from the digestively active part of the small intestine, which improves metabolism

Potential Disadvantages of Single Anastomosis Duodenal–ileal Bypass with Sleeve Gastrectomy (SADI) Surgery

Sadi has potential downsides and complications unlike other weight-loss surgery procedures, including:

  • Bleeding/blood clots
  • Dumping syndrome
  • Gallstones
  • Hernia
  • Infection
  • Nausea, vomiting, diarrhea or constipation
  • Low blood sugar
  • Malnutrition or dehydration
  • Leaking
  • Obstruction
  • Spleen and other organ injuries
  • Stenosis (narrowing)
  • Ulcer (hole)
  • Vitamin or mineral deficiencies

SADI After Sleeve Gastrectomy

For patients who have already undеrgonе an ileal bypass with sleeve gastrectomy, SADI can be a complеmеntary procedure. It enhances the weight loss effects of thе initial surgery, making it a two-stеp process towards achiеving a hеalthiеr weight.

In conclusion, Single anastomosis duodenal–ileal bypass with sleeve gastrectomy (SADI) surgery offers a promising path for those struggling with severe obesity. It’s a minimally invasive, effective option with a high success rate in weight loss and managing conditions like type 2 diabetes. While preparing for and recovering from SADI requires strict dietary adherence, the long-term benefits, including significant weight reduction and improved metabolic health, are well worth the effort. Remember, like any surgery, it has risks, so thorough consultation with a healthcare professional is essential for a safe and successful journey

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