SADI-S as a second procedure after sleeve gastrectomy

Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a new operation for morbid obesity based on the biliopancreatic diversion in which a sleeve gastrectomy is followed by an end-to-side duodeno-ileal diversion.

After a sleeve gastrectomy, many surgical options are available for patients with insufficient weight loss.  The duodenal switch is typically considered the operation that results in the greatest weight loss, although it is, perhaps unjustly, regarded as technically difficult and may be accompanied by severe side effects. A single anastomosis duodeno-ileal bypass with a sleeve gastrectomy is a simplification of the duodenal switch that may behave as a standard biliopancreatic diversion but is easier and quicker to perform. The preservation of the pylorus makes the reconstruction possible in one loop, which reduces operating time and requires no mesentery opening.

Given its effectiveness as a primary surgery, it is hypothesized that it would be successful as a second-step operation.

Antonio Torres MD, Professor of surgery at the Hospital Clinico San Carlos presents an interesting talk about the SADI-S procedure, confirming that it is a safe operation that offers a satisfactory weight loss for patients subjected to a previous sleeve gastrectomy with minimal side effects and complications.