SADI

SADI combines two mechanisms in one operation. First, a sleeve gastrectomy reduces the stomach to a narrow sleeve, so a small meal satisfies you. Second, the first part of the small bowel is divided just beyond the stomach and joined further down, leaving between 2.5 and 3 metres of small bowel to absorb food, so fewer calories are taken up.

Unlike the gastric bypass, SADI keeps the pylorus, the natural valve at the outlet of the stomach, which helps food leave the stomach in a controlled way. The single join keeps the operation simpler than the traditional duodenal switch it was developed from, while the longer bowel length is designed to reduce the risk of malnutrition that the older operation carried.

SADI is one of the most powerful weight loss procedures we offer, so it tends to be considered where that power is needed: patients with a higher BMI, patients whose type 2 diabetes needs a strong metabolic effect, and increasingly, patients experiencing weight regain after a sleeve gastrectomy, where SADI can be performed as a second stage building on the existing sleeve.

The standard eligibility criteria apply: generally a BMI of 35 or above, or 30 or above with a weight related health condition, with lower thresholds for people of Asian descent. Because long term outcome data for SADI is still limited, the decision is made carefully with your surgeon, weighing the expected benefit against the demands of the procedure. Check where you stand with our BMI calculator.

Compared with the sleeve gastrectomy alone, SADI adds a malabsorptive component, producing greater weight loss and a stronger effect on conditions such as type 2 diabetes, at the cost of greater lifelong nutritional demands. Compared with the gastric bypass, SADI involves a single join rather than two and preserves the pylorus.

The trade off is straightforward to state: SADI offers some of the strongest weight loss available, and in return it asks the most of you afterwards, with strict lifelong vitamin supplementation and regular blood test monitoring. Your surgeon will lay out how it compares with the sleeve gastrectomy and gastric bypass for your situation at your consultation at one of our Melbourne locations.

Eating after SADI progresses in stages, guided by our bariatric dietitian: fluids, then pureed foods, then soft foods over approximately four to six weeks, before settling into a normal healthy diet in small portions.

Because a significant length of small bowel no longer absorbs food, daily multivitamins and minerals are essential for life after SADI, with particular attention to protein intake, iron, calcium and the fat soluble vitamins. Regular blood tests through our follow up program are not optional extras, they are part of the operation's long term safety, and our Specialist Physician reviews your results with you.