SADI-S operation for the treatment of obesity in Türkiye

SADI-S operation is a safe new procedure targeting patients with excessively high body mass index (BMI) and is less invasive than gastric bypass and offers excellent results in terms of weight loss.

The SADI-S procedure was first mentioned in medical terminology in 2007 and until now there are not many surgeons experienced in this procedure.

What is the SADI-S procedure?

It is a procedure in which 80% of the section through which the material is absorbed is removed with gastric bypass and the creation of a gastric sleeve , which leads to the creation of two separate pathways and one common channel.

The annular-digestive tract (the shorter of the two pathways) allows food to flow from the stomach into the common duct, and the annular-pancreatic tract (the longer) allows bile to flow from the liver into the common duct. Thus reducing the time food mixes with digestive juices. And thus reduces the amount of calories absorbed by the patient’s body, which in turn leads to an acceleration of weight loss.

SADI-S was first performed as a new type of duodenal switch surgery. Its main benefit is that only one intestinal anastomosis is performed instead of two resulting in a shorter surgery time and a reduced risk of a leaky gut.

SADI-S can be performed as two separate procedures for obese patients. First, by performing a sleeve gastrectomy , which gives patients enough time to lose weight and increase the level of safety to continue to the second stage , which includes rerouting the small intestine.

Differences between DS and SADI-S

The SADI-S operation is performed through a laparoscope (which is a long, thin tube with a camera in the front), which explains the need to make several small incisions in the abdominal area. The vertical sleeve created is also slightly larger than those used in traditional sleeve gastrectomy . 

The DS duodenal switch bypasses a much larger part of the small intestine and this leads to continued malabsorption of vitamins, minerals and even protein. (In some people) These people are offered nutritional supplements, but for some patients this is not enough and this leads to long-term problems In contrast, the SADI-S process maintains The small intestine has approximately 10 linear feet of nutrient absorption. In other words, instead of having only two feet as in DS surgery, the SADI-S process preserves 5 feet of small intestine. In addition, the risk of leakage or blockage is reduced. Minimizing the possibility of intestinal entrapment in the space between the intestinal segments in SADI-S because the small intestine is not divided into two parts.

Differences between roux-en-y bypass surgery and SADI-S:

SADI-S preserves the pylorus (the muscular part of the stomach that separates the stomach from the duodenum). It is the outlet of the stomach that allows food to pass into the small intestine. It also prevents partially digested food and digestive juices from returning to the stomach again. Preserving this muscle has benefits, the most important of which is controlling the emptying of food and reducing dumping syndrome (after cutting the stomach). This is unlike bypass surgery. in a way (roux-en-y).

Who qualifies for the SADI-S process?

A person must have a high degree of determination, commitment, and persistence in taking vitamin and protein supplements permanently, and in constant communication with the doctor and nutritionist.

This is in addition to meeting other criteria for SADI-S surgery, which are:

• The BMI must be greater than 50 because these people are at high risk of developing other obesity-related conditions. An example is type 2 diabetes or heart disease .
• The mass index ranged between 30-49, in addition to having type 2 diabetes or/and heart disease or/and metabolic syndrome (high blood pressure, diabetes, high cholesterol, sleep apnea, and excess fat around the waist circumference).

Who is considered ineligible for the SADI-S process?

• Patients who need a long-term steroid or non-steroidal anti-inflammatory drug (NSAID) and who drink a lot of alcohol or use illegal drugs. Not candidates for SADI-S because these materials can cause irritation leading to ulcers.
• Those who suffer from irritable bowel syndrome and diarrhea. They are not considered ideal candidates now that SADI-S increases the frequency of their bowel movements.
• This procedure is not suitable for people with severe acidic gastroesophageal reflux disease as the SADI-S procedure can exacerbate the condition in some people.

Pros and Advantages of the SADI-S Process:

One of the main advantages of the procedure is that patients are able to eat “almost normal” meals. In smaller quantities than those who underwent gastric bypass surgery , this increases patient satisfaction. Other advantages are:

• Faster recovery and the ability of patients to return to work one week after surgery.
• It is a less invasive procedure with fewer complications such as hernias, scar tissue formation, and other inconveniences.
• Rapid weight loss, losing 22 kg during the first months, and losing 90% of excess weight during the first 6-8 months.
• Regulating sugar levels.
• Reducing hunger by removing the part of the stomach that produces Ghrelin, the hormone responsible for feeling hungry.

Disadvantages and complications of the SADI-S procedure:

The SADI-S procedure carries risks like other surgeries and also acid buildup, but there is no data regarding long-term complications after the procedure.

Preparation for the “SADI-S” procedure:

Two weeks before the surgery, the patient follows a special diet that helps reduce belly fat and shrink the size of the liver. This allows the surgeon to more easily navigate the internal structures of the abdomen while using the laparoscope. The diet should be high in protein and low in carbohydrates, calories and fat.

Obesity, diabetes and nutrition operations in Türkiye

The increasing number of obese people around the world has made it an increasing and common problem. Obesity patients constitute approximately 13% of adults in the world. It is a complex medical condition and is affected by several factors, most of which are biological and beyond complete personal control. In most cases, diets and sports do not work and surgical intervention is required.

 Obesity increases the risk of many diseases, such as cardiovascular disease, diabetes, and arthritis. There is a close relationship between obesity and diabetes, and studies have shown that about 85% of diabetics are overweight.

Our focus at REHABTÜRK is on diagnosing and treating obesity, diabetes and related complications. 

We have a team of specialized doctors, including surgeons, nutritionists and medical advisors, to ensure the best treatment results.

Treatment in Türkiye:

The medical staff of surgical teams, doctors and consultants in REHABTÜRK can provide the best treatment options and free consultations – by striving to keep abreast of the latest medical technologies and methods.

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