SADI / SIPS
This procedure has two commonly used and interchangeable names. One name is SADI which stands for Single Anastomosis Duodeno-Ileo Bypass. The second name is SIPS which stands for Stomach Intestinal Pylorus Sparing Surgery.
SADI/SIPS Interchangeable Names
This procedure was first described in 2007 with the goal of combining two effective mechanisms of weight loss, restriction and malabsorption while eliminating the undesirable aspects of the gastric bypass and traditional duodenal switch.
What is SADI / SIPS?
A simple way of understanding the SADI is that it is a modified version of the Duodenal switch, that eliminates the need for a second anastomosis (intestinal connection).
When performed as a primary operation, weight loss is approximately 70-75% of excess body weight. This is higher than either the Sleeve Gastrectomy or Gastric Bypass.
In the United States, each year since 2015 this procedure has become more commonly performed and mainstream.
The operationconsists of twocomponents
1. A Sleeve Gastrectomy
Removal of most of the lateral portion of the stomach, leaving a tube-shaped stomach or “sleeve.”
2. Duodeno-lleo Connection
The first portion of the small bowel (duodenum) is divided and reconnected approximately halfway down the length of the intestine.
How it Works
The first portion of the surgery, the sleeve gastrectomy, results in restricting the volume of food that can be taken at one time. This also leads to a significant reduction in appetite due to the loss of the portion of the stomach that secretes the hormone Ghrelin. Ghrelin is a powerful appetite stimulator; therefore, hunger levels decrease dramatically when it is no longer produced.
The second portion of the operation, the duodeno-ileo connection, limits the body’s ability to absorb all the calories that are ingested. This typically results in the average patient absorbing only 55-70% of the calories taken in each day.
Advantages
Greater average weight loss that either the Sleeve Gastrectomy or Gastric Bypass
Less “Dumping Syndrome” than with the Gastric Bypass
Significantly reduced risk of internal hernia and anastomotic ulceration when compared to the Gastric Bypass or Duodenal Switch
Very effective as a “Second Stage” operation for patients who have already had a Sleeve Gastrectomy and desire additional weight loss
Disadvantages
This operation causes malabsorption not only of calories but all the ingested contents, including protein, vitamins and nutrients. Therefore, it is very important that patients are compliant with taking the recommended vitamins and minerals.
Increased frequency of bowel movements. Most patients will experience an average of two to three times as many bowel movements daily as they normally have preoperatively.
Given that the procedure is relatively new (less than 10 years), there is limited long term data.
Is the SADI / SIPS better than a Duodenal Switch
Although the two procedures are very similar, SADI is somewhat less invasive. This is because there is one intestinal reconnection rather than two as with a Duodenal Switch. This results in a much lower risk of internal hernia but unfortunately, because the procedure is new there is no long term data (>10 years) available at this time for effective comparison. Talk to your surgeon about the two options and he/she can guide you in making this choice.
How much weight can I expect to lose with a SADI / SIPS?
As a primary operation the average weight loss is 70-75% of excess weight.
As a “second stage” operation after a sleeve, the average weight loss is 45-50% of excess weight.
