Bypass tipo SADI-S

thumb

SADI-S (single anastomosis duodeno-ileal bypass-with Sleeve Gastrectomy)

 

 

SADI-S or Single Anastomosis Duodeno-Ileal bypass with Sleeve Gastrectomy is a novel bariatric procedure, representing a simplification of the duodenal switch. It is malaborbitive procedure, performed laparoscopically, very similar to the standard duodenal switch operation, except that the small intestine is only transected at one point instead of two, requiring a single anastomosis, thus determining a reduction in the operative time and risk of perioperative complications.
SADI can be performed as a first step in the treatment of obese patients or as a revision surgery after failed Sleeve Gastrectomy.

 

The procedure consists first in the creation of a gastric pouch, by performing a Sleeve Gastrectomy (in primary procedures) and then in the resection of duodenum, by preserving the pylorus. Then we create an anastomosis between the proximal duodenum and the distal ileum, determining a common channel of 250 cm, where the nutrients are absorbed. Weight loss is achieved both through restriction of food consumption and malabsorption, which results in very good long-term weight loss maintenance.

 

This procedure is very effective as a revision surgery after failed Sleeve Gastrectomy, for weight regain of insufficient weight loss or lack of remission of comorbidities (such as diabetes, hypertension, dyslipidemia).
As for all malabsorbitive procedures, it is of paramount importance after this type of surgery the compliance to vitamin supplementation and to follow-up, to avoid nutritional deficiencies. Bowel movements can be very frequent in the early postoperative period, but this can be mitigated by following dietetic indications.