Sadi-S | Prof. Dr. Haluk Ünalp

Sadi-S

WHAT IS SADI-S MEAN?

SADI-S is the initials of singleanastomosisduodeno-ileal bypass withsleevegastrectomy in English. In other words, tube stomach + single anastomosis and duodeno-ileal bypass.

WHAT IS SADI-S SURGERY?

In addition to a tube stomach application, SADI-S surgery involves closing the small intestine (duodenum) at the exit of the stomach (switch) and mouthing the lower part of the small intestine with the duodenum part at the exit of the stomach.

HOW IT IS MADE ?

This surgery can be done with a closed method (laparoscopic). Gastric sleeve surgery is performed with the classical method to create a small stomach pouch. Stomach volume is reduced, but stomach volume is larger than conventional tube stomach. Then, the duodenum is cut and closed with special tools to protect the pylorus (stomach outlet). From the junction of the small and large intestines, it is marked 250 (variable) by counting, and a duodenum-small intestine anastomosis is made by pulling it towards the duodenum. Therefore, the nutrient is absorbed through the common channel of about 2.5 meters. Thus, both the food volume of the stomach is reduced (tube stomach) and the absorption of the food taken is limited (duodenum-intestinal anastomosis).

SADI-S, which is an obesity surgical technique, is a type of duodenal switch performed with a single anastomosis. With this surgery, on the one hand, the rate of food intake is reduced because the gastric tube is formed (restrictive approach to food intake), on the other hand, the absorption of the food taken is reduced because it disables the small intestine that can be absorbed (approach restricting food absorption).

WHAT ARE THE DISADVANTAGES?

- Patients may need to take vitamin supplements (A, D, E, K and minerals) throughout their life.
- Frequent control and follow-up is required.
- There may be swelling in the gallbladder and the risk of developing gallstones is higher than normal.
Surgical risks are similar to other obesity techniques. (such as bowel perforation, anastomotic leak, infection, abscess, venous thrombosis and pulmonary embolism, or intestinal obstruction in the long term).

WHAT ARE THE ADVANTAGES?

- It controls diseases accompanying obesity such as diabetes, hyperlipidemia, sleep apnea and hypertension.
- The difference from duodenalswitch surgery is that it is applied with a single anastomosis.
- Dumping syndrome is not seen since the pylorus is protected.
- Since the pylorus is protected, the diet is better tolerated than other surgeries.

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