Single Anastomosis Duodeno-Ileostomy

What is Single Anastomosis Duodeno-Ileostomy (SADI) Surgery?

Duodeno-ileostomy surgery is a highly effective weight loss procedure designed for individuals struggling with severe obesity. It combines gastric reduction with intestinal bypass to promote rapid weight loss. The SADI procedure preserves more nutrient absorption than the classic duodenal switch (DS) procedure, however, vitamin and protein deficiencies can still occur. Lifelong supplementation and monitoring can be necessary for some patients.

A modern variation, the single anastomosis duodeno-ileostomy (SADI), simplifies the classic DS procedure by creating only one connection (anastomosis) between the stomach and the small intestine instead of two. This adjustment results in:

• A longer common channel, allowing for better absorption of essential nutrients.

• Fewer bowel movement issues compared to the traditional biliopancreatic diversion (BPD) with duodenal switch.

• Lower risk than traditional DS, but still higher than sleeve or bypass. Lifelong supplements and monitoring remain essential.

Candidate Characteristics

SADI weight loss surgery is a highly effective option for individuals struggling with severe obesity. It is generally recommended for patients with a body mass index (BMI) of 50 or higher, or for those with significant metabolic disease, such as advanced type 2 diabetes.

It is best suited for individuals who require substantial and sustained metabolic improvement and who have not achieved lasting results through lifestyle changes. 

Outcomes are promising, however, the long-term data is still emerging. Results depend on your health history and adherence to aftercare. The best way to know if SADI fits your goals and risk profile is a consultation with our bariatric team.

The SADI is one of several different bariatric procedures offered at our private surgery clinic in Montreal; if you want to explore your options call (514) 922-5055 or use our patient questionnaire form to get started. 

The Single Anastomosis Duodeno-Ileostomy Procedure - What to Expect

The single anastomosis duodeno-ileostomy is a bariatric procedure that promotes weight loss through a combination of gastric reduction and intestinal bypass. The procedure begins with a sleeve gastrectomy, where a portion of the stomach is removed to limit food intake. This reduction helps patients feel full with smaller portions, setting the foundation for significant, sustained weight loss. Unlike other weight loss procedures, SADI also modifies the small intestine to alter nutrient absorption, which enhances its overall effectiveness.

During the intestinal bypass phase, the duodenum (the first part of the small intestine) is rerouted to create a single connection (anastomosis) with the lower section of the small intestine. Unlike the traditional biliopancreatic diversion with duodenal switch (BPD/DS), which involves two separate connections, SADI preserves a longer common channel—the portion of the intestine where food mixes with digestive enzymes. This modification improves nutrient absorption, reducing the risk of vitamin deficiencies and excessive bowel movements often associated with intestinal bypass procedures. The digestive process is rerouted so that protein and fat digestion primarily occur in the final 7 feet of the small intestine, promoting weight loss while maintaining essential nutrient absorption.

This procedure is performed using minimally invasive techniques and typically lasts under two hours. Most patients stay in the hospital for 2-3 days post-surgery and can return to normal activities, including work, within 2-4 weeks. Recovery varies by individual. Lifelong follow-up with your bariatric team, including lab monitoring and supplements, is essential to avoid complications such as anemia, osteoporosis, and malnutrition.

If you're considering bariatric surgery, our team at Clinique Michel Gagner can help you explore your options. Visit our fees page to learn more about costs, and consult our surgery guidelines to learn more about what to expect before and after your procedure.