​​SADI-S (single anastomosis duodenal-ileal bypass with sleeve gastrectomy) surgery combines a sleeve gastrectomy with duodeno-ileal bypass, a variation on the duodenal switch. This combo restricts how much you can eat, as well as how many calories (and nutrients) “This technique is gaining traction and offers promising outcomes, especially for patients who are revising a previous sleeve gastrectomy,” according to board-certified bariatric surgeon Dr. Reza Keshavarzi in Miami, FL. He’s especially excited about a “newer magnet-assisted version” of the procedure, “a promising option due to its lower complication profile compared to traditional techniques.”
At their respective practices in Tijuana, Mexico, bariatric surgeons Dr. Jorge Maytorena and Dr. Gabriela Rodriguez Ruiz both offer ​​SADI-S. They both say the procedure is still relatively uncommon, but its popularity is growing as more practices offer it and patient awareness grows.Â
Dr. Maytorena considers SADI-S “superior [to sleeve gastrectomy] in terms of weight loss, as long as the patient does not have acid reflux. In that case, the best option would be a Roux-en-Y gastric bypass.” Dr. Ruiz also points out that “SADI-S is better at long term remission of diabetes” than duodenal switch.
The first step in preparing for the procedure is often a GLP-1 like semaglutide, says Dr. Ruiz. “I usually recommend GLP-1 to prep patients for surgery as an aid to help them start their preparation and losing weight.”
As more patients realize the limitations of GLP-1s, both in terms of how much weight loss can be achieved and the longevity of results, they’re turning to weight loss surgeries like this one to lose up to 80% of excess weight—and sometimes more.Â
“In my practice, our patients often lose close to 100 percent of their excess weight,” says Keshavarzi. Beyond the surgery itself, “I personally guide each patient through a long-term protocol focused on maintaining or increasing lean muscle mass and optimizing fat loss,” he explains.
All of the surgeons we spoke to agree that there’s no one right solution for every patient. “For someone with metabolic disease or a history of significant weight regain after a sleeve, SADI-S may be appropriate. But for many others, starting with a sleeve gastrectomy and a solid support plan is the right path,” says Dr. Keshavarzi. “It’s also important to see a doctor that is able to do all the procedures and not just one because they will think their one procedure is the best fit. Go to someone who can give you an unbiased evaluation.”
Dr. Maytorena also stresses the importance of consulting with an expert to determine which procedure will be the healthiest choice for you, with the fewest side effects. “A thorough evaluation is necessary before bariatric surgery, as each patient has different needs that must be considered.”
