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).