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Bariatric Surgeon India

SADI Procedure- An Exceptional Option In Weight Loss Surgery

Some people need the most aggressive options for bariatric surgery to achieve their weight loss goals. In these cases, the most common option is the Single anastomosis duodeno Ileal  bypass (SADI) surgery. It offers very high weight loss with fewer side effects than the older duodenal switch surgery.

Patients with excessive body mass index (BMI) have other surgical alternatives at Sunshine Hospital. Dr Venu Gopal Pareek and his bariatric staff are now offering SADI-S (Single Anastomosis duodenal bypass), a new, safe bariatric procedure with a restrictive and malabsorptive component. SADI-S is less invasive than Roux-en-Y bypass but still offers excellent weight loss results.

This article is provided by Dr Venu Gopal Pareek, which gives information about the SADI procedure.

What is SADI?

Modified duodenal switch (DS) with single anastomosis (SADI / SIPS) involves creating a gastric sleeve that removes approximately 80% of the stomach. The malabsorbent portion diverts part of the small intestine and creates two separate pathways and a common channel. The digestive chain, the shorter of the two pathways, allows food to flow from the stomach into the common tract. The longer route, the biliopancreatic chain, carries bile from the liver to the common duct. This variance limits the time the food mixes with the digestive juices and reduces the number of calories the patient’s body absorbs, resulting in increased weight loss.

SADI-S, also known as SIPS surgery, was first performed as an updated version of duodenal surgery. Its main advantage is that only one intestinal anastomosis is performed instead of two, resulting in shorter surgery time and reduced intestinal leakage risk. In most obese patients, SADI-S can be performed as two separate procedures. First, a limiting gastric cuff will be created, which will allow the patient to lose weight, and in the end, it will be safer for them to proceed to the second part, which involves diversion of the small intestine.

For whom is this procedure useful?

SADI is especially useful for diabetic patients and has the highest resolution for type 2 diabetes. It is also useful for patients who are very obese and have less risk of long-term weight recovery. This is a good revision procedure for weight loss after sleeve gastrectomy. Since the sleeve often remains intact and is only connected to the distal bypass, the operating time and need to treat the sleeve are reduced.

SADI Procedure

SADI is perhaps the most effective and reliable weight-loss surgical procedure we have today. Weight loss of 75-95% is achieved and maintained. This procedure is a newer development of an older procedure, the duodenal switch. SADI can be performed as a primary one-step laparoscopic procedure involving a gastric sleeve (not as tight as a normal gastric sleeve) or as a second stage or revision of the previous arm bariatric procedure to treat inadequate weight loss or weight recovery.

This procedure is performed using an initial laparoscopic incision to reduce the stomach’s size to the size of a gastric sleeve. The small intestine immediately following the stomach is called the duodenum. It separates as soon as the stomach and intestinal loop go up and connect this part of the duodenum. This causes food with a reduced capacity (gastric sleeve) to pass through the stomach, then pass through most of the duodenum, and the next part of the intestine is the jejunum. In this way, the food goes directly to the ileum (the last half to third of the small intestine). We guarantee a minimum of 300 cm of the ileum to absorb food (the small intestine’s total length is approx. 500-600 cm).

SADI works by combining a restrictive component and a very important metabolic or malabsorbent component (reducing calorie and nutrient absorption).

How does it work?

The SADI procedure causes significant malabsorption as calories are no longer easily absorbed once they are performed. Food moves very quickly through the bypass and into the column. This means that there is only a very limited time for calories to be absorbed from the intestines. This causes the intestines to relax for the first year (or longer), but then things calm down over time. Carbohydrates should be avoided as they are closely linked to the causes of diarrhoea.

SADI also increases the production of the incretin hormone. This group of metabolic hormones stimulates a decrease in blood sugar levels by increasing insulin secretion released by the pancreas. The calories released into the small intestine in the unprocessed form stimulate the FXR receptors and trigger incretin release. This hormone, in turn, acts in the hypothalamus to turn off appetite and help you avoid food.

SADI recovery time

Most patients need 2-3 nights in hospital after surgery and 3 to 14 days off, depending on their occupation. Most patients can start walking within a few days and can start more exercise within three weeks.

What can a patient expect from SADI?

The main advantage of duodenal switch surgery (SADI-S or SIPS) is limiting absorption (part of the operation of the pods limiting the amount of food you can eat) by significant malabsorption of calories (intestinal diversion reduces absorption) of combined fat and calories). This results in the highest rates of unhealthy weight loss with the lowest risk for significant weight recovery. On average, patients can lose 80-100% of their unhealthy weight in about nine months.

Another major benefit of the duodenal switch is that it is very useful in dealing with obesity-related health problems such as high blood pressure, obstructive sleep apnea, and high cholesterol. It has the highest success rate of all bariatric surgeries in treating Diabetes II.


  • Lack of protein malnutrition and vitamin deficiency
  • Facilitates the absorption of iron, calcium and vitamin B12
  • Beneficial effect on diabetes
  • Ability to eat normally as a sleeve gastric
  • There is no dumping syndrome because the pylorus is preserved
  • There is no increased risk of anastomotic ulcers
  • There is no increased risk of an internal hernia
  • An excellent technique for unsuccessful sleeves as it avoids anastomoses in the area of adhesion and compaction from previous operations
  • Avoiding the contradiction of gastric cancer in the stomach residue due to biliary reflux, such as the omega-loop or mini gastric bypass


There is always a need for people (patients and surgeons) to turn to fairly new procedures to make progress in medicine.

We never offer a procedure regarding bariatric surgery at Dr Venu Gopal Pareek unless there is adequate training and research. We offer SADI-S to selected patients after full disclosure of the current status of the procedure. All patients are examined carefully for their current health status, medical status, weight loss history, etc. The patient is then monitored long-term by a multidisciplinary team using a protocol similar to that used by units performing duodenal switches.

If you are interested in discussing the SADI procedure, Contact Dr Venu Gopal Pareek at 091777 77715  for a consultation.

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