The Loop duodenal switch (SADI-S) procedure is the most recently endorsed weight loss surgical operation by the American Society for Metabolic and Bariatric Surgery. While similar to the BPD-DS, the SADI-S is simpler and takes less time to perform as there is only one surgical bowel connection.

• The operation starts the same way as the sleeve gastrectomy, making a smaller tube-shaped stomach.


• The first part of the small intestine is divided just after the stomach.


• A loop of intestine is measured several feet from its end and is then connected to the stomach. This is the only intestinal connection performed in this procedure.

When the patient eats, food goes through the pouch and directly into the latter portion of the small intestine. The food then mixes with digestive juices from the first part of the small intestine. This allows enough absorption of vitamins and minerals to maintain healthy levels of nutrition. This surgery offers good weight loss along with less hunger, more fullness, blood sugar control and diabetes improvement.

Advantages of the SADI-S procedure

Highly effective for long-term weight loss and remission of type 2 diabetes
Simpler and faster to perform (one intestinal connection) than gastric bypass or BPD-DS
Excellent option for a patient who already had a sleeve gastrectomy and is seeking further weight loss
We usually perform these surgeries robotically

Disadvantages

Vitamins and minerals are not absorbed as well as in the sleeve gastrectomy
Potential to worsen or develop new-onset reflux
Risk of looser and more frequent bowel movements