SADI-S
Single‑Anastomosis Duodenal Switch
Next-Level Weight Loss Surgery
SADI-S is one of the most effective bariatric options available today, offering powerful weight-loss and metabolic benefits for patients who need more than a standard sleeve. At 360 Sleeve, this advanced surgery is performed by our experienced bariatric team in our state-of-the-art surgical facility, with comprehensive long-term support to help you achieve lasting results.
What is SADI‑S?
SADI‑S (also called single‑anastomosis duodenal switch) starts with a vertical sleeve gastrectomy (gastric sleeve surgery) and then connects the first part of the small intestine (duodenum) to a more distant segment of small bowel. Food still takes a natural route, but part of the intestine is bypassed—delivering restriction + a stronger metabolic/absorption change.
Why some patients consider it:
- Greater average weight‑loss potential vs. gastric sleeve alone
- Strong type 2 diabetes and metabolic improvements
- One bowel connection (vs. two in classic duodenal switch)
What is Gastric Sleeve Surgery ?
( Vertical Sleeve Gastrectomy or VSG )
Gastric Sleeve Surgery removes a portion of the stomach to create a smaller, banana‑shaped sleeve. It reduces hunger and portion sizes while keeping food on a normal path (no intestinal rerouting).
Why some patients consider it:
- Powerful, well‑studied weight‑loss for many patients
- Simpler anatomy and vitamin routine vs. bypass procedures
- Often a good first‑line surgical option
Who Is a Candidate for SADI-S?
SADI-S may be appropriate for patients who:
Have a BMI of 40+
Have a BMI of 35+ with metabolic conditions (such as type 2 diabetes)
Need greater weight loss than sleeve surgery alone may provide
Have struggled with long-term weight maintenance
Are seeking stronger metabolic improvement
Eligibility is determined after a full medical evaluation with our bariatric team.
Expected Weight Loss with SADI-S
SADI-S is designed for patients who require greater metabolic support and more substantial long-term weight loss than sleeve surgery alone.
Because it combines stomach reduction with intestinal rerouting, it delivers both restrictive and metabolic effects — supporting powerful and durable results.
What Patients Can Expect
While results vary based on starting BMI, adherence, and overall health, many patients experience:
Greater total weight loss compared to sleeve surgery
Significant reduction in excess weight : ~70–85% excess weight loss
Strong long-term weight maintenance
Continued metabolic support years after surgery
Patients with higher BMIs often benefit most from the added metabolic impact of SADI-S.
Health & Metabolic Benefits
Beyond weight loss, SADI-S can significantly improve obesity-related conditions by altering gut hormones and improving insulin signaling.
Potential Benefits Include:
Improvement or remission of type 2 diabetes
Better blood sugar control
Reduced insulin resistance
Improvement in high blood pressure
Improved cholesterol levels
Reduced sleep apnea symptoms
Improvement in fatty liver disease
The combination of stomach reduction and shortened intestinal absorption creates a powerful hormonal and metabolic shift that supports both weight loss and overall health improvement.
Weight Regain: Sleeve vs SADI-S
Gastric Sleeve
~50–70% excess weight loss
Some patients may regain 10–20% over time
Strong results with proper aftercare
SADI-S
~70–85% excess weight loss
Enhanced metabolic support
Weight regain rate is less common than sleeve
- When regain occurs, it is commonly in the range of ~5–10% of the weight initially lost
Long-term success depends on lifestyle habits, vitamin compliance, and structured follow-up care.
Gastric Sleeve vs. SADI-S
While both gastric sleeve and SADI-S promote significant weight loss, SADI-S adds an enhanced metabolic component. Here’s how they compare.
Gastric Sleeve Surgery
VSG (Vertical Sleeve Gastrectomy)-
Main Approach: Reduces stomach size only
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Expected Weight Loss: ~60–70% excess weight loss
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Metabolic Impact: Strong
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Ideal For: Patients needing significant weight loss, fewer nutritional demands
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Impact on Hunger Hormones: High ghrelin reduction
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Diabetes Improvement: Very good
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Nutrient/Mineral Risk: Moderate
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Digestive Changes: Minimal, more “physiologic”
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Surgery Time: Shorter
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Recovery: Typically faster
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Best For: Patients with a BMI of ~30–45, and first-time bariatric patients
SADI-S
(Single Anastomosis Duodeno-Ileal Bypass)-
Main Approach: Sleeve + intestinal bypass
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Expected Weight Loss: ~80–90% excess weight loss (more powerful)
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Metabolic Impact: Very strong (more hormonal + malabsorption effects)
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Ideal For: Patients needing maximal weight loss or have weight regain after sleeve
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Impact on Hunger Hormones: High ghrelin reduction + added metabolic change
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Diabetes Improvement: Often excellent, higher remission rates
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Nutrient/Mineral Risk: Higher, requires strict vitamins + monitoring
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Digestive Changes: More rerouting; may cause softer stools / malabsorption
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Surgery Time: Slightly longer
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Recovery: Similar timeframe, but more long-term follow-up
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Best For: Revision from sleeve or patients with BMI > 40
Which Procedure is Right For Me?
Every patient is unique. During your consultation, our surgeons review your health history, weight-related conditions (such as diabetes or sleep apnea), prior surgeries, reflux symptoms, and personal goals to help determine the safest and most effective option.
Gastric Sleeve (VSG)
A great choice if you want a powerful, simpler procedure with fewer long-term nutritional demands—ideal for many first-time bariatric patients who meet the candidacy criteria.
SADI-S
Recommended for patients who need a stronger metabolic effect, have a higher BMI or significant metabolic disease, or those considering revision surgery after a previous sleeve that no longer provides sufficient weight loss or diabetes control.
Your candidacy for either procedure is determined through a comprehensive assessment by our bariatric surgeons.
Keep Reading
Learn more about gastric sleeve surgery
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