SADI-S Surgery

Who is it for?

SADI-S may be right for you if you are an adult and one of the following applies:

• You have a very high body mass index (BMI), usually 50 or more.
• You have severe type 2 diabetes along with obesity.
• You had a sleeve gastrectomy before, and your weight loss was not enough or the weight came back.

Because the body absorbs fewer vitamins after SADI-S, it is only suitable if you are ready to take supplements and attend follow-up for life. If you have strong acid reflux, another operation may suit you better.

How is it performed?

• You are fully asleep under general anesthesia. The operation is done by keyhole surgery through 5 to 6 small cuts and takes about one hour.
• First, a sleeve gastrectomy is made, using Dr. Ahmed’s Identical Sleeve technique so the new stomach is straight, with no twist.
• The first part of the small intestine (the duodenum) is divided just after the stomach. The natural valve at the stomach outlet, called the pylorus, is kept.
• The stomach is then joined to a loop of the lower small intestine, about 300 cm from its end. This is the operation’s only join.
• Food now travels through a shorter length of intestine, so the body absorbs fewer calories, especially from fat.
• Because the pylorus is kept, food leaves the stomach at a normal pace, and “dumping” is rare. The join is tested for leaks before the operation ends.

Before surgery

• A full check-up: blood tests including vitamin levels, an abdominal ultrasound, an upper endoscopy (a camera test of the stomach), and a visit with the anesthesia doctor.
• A session with our dietitian. If your BMI is very high (over 60), you will also follow a low-calorie diet for 1 to 2 weeks before surgery, to shrink the liver and make the operation safer.
• Stop smoking at least 4 to 6 weeks before surgery.
• Tell us about all your medicines, especially for diabetes, blood pressure, and blood thinning.
• Our Fast Track program starts now and continues during and after your operation, to help you recover sooner.

Recovery and follow-up

• You will walk within a few hours and start sipping water on the first day. Most patients go home after one night.
• Your diet moves in steps over about six weeks, from fluids to normal meals. Protein is especially important after SADI-S, so include it at every meal.
• You will take vitamins every day for life: a multivitamin, vitamins A, D, E, and K, calcium, iron, and vitamin B12. This is not optional; it protects your bones, blood, and eyesight. For the first 6 months, you will also take a medicine that protects you from gallstones.
• Blood tests at 3, 6, and 12 months, then once a year, help us adjust your supplements.
• Many patients have two or three soft bowel movements a day. Fatty food makes them looser.
• Follow-up visits are at 1 week, 1 month, 3, 6, and 12 months, then twice a year, in the clinic or by video consultation.

What results can I expect?

SADI-S gives very strong weight loss. Most patients lose about 70–90% of their extra weight over the first 12 to 18 months, and some reach up to 95%. Type 2 diabetes often improves greatly or goes into remission. SADI-S is newer than gastric bypass, so long-term studies are still growing, but early and medium-term results are very encouraging.

Conditions That May Improve After SADI-S Surgery

1. Morbid Obesity
2. Type 2 Diabetes

What are the risks?

Every operation carries some risk, and we will explain yours at your consultation. The main risks are:

• A leak. This is very rare today, thanks to advanced staplers and the surgeon’s experience. If it happens, it shows within the first 7 to 10 days after surgery.
• Bleeding, in about 1 in 100 patients. It usually settles with close monitoring and treatment, without another operation.
• Shortages of vitamins (especially A, D, E, and K), minerals, and protein. The risk is higher than after other operations, which is why lifelong supplements and blood tests matter so much.
• Bloating, gas, and diarrhea, especially after fatty meals. Keeping the stomach valve (pylorus) helps make them less likely, and eating less fat is the main way to prevent them.
• New or worse heartburn (reflux).
• Gallstones. Fast weight loss and drinking too little water can cause them, and without prevention, about 25–30% of patients develop them. A protective medicine we prescribe for the first 6 months lowers this to about 5%, close to the usual rate in the general population.
• Blood clots in the legs or lungs. Walking early and blood-thinning injections lower this risk.
• Some weight regain over the years. Regular follow-up with our nutrition team is the best way to prevent it.

Why Choose Our SADI-S Surgery Program?

• Experienced bariatric surgeons
• Advanced laparoscopic surgical techniques
• Personalized treatment plans
• Comprehensive preoperative assessment
• Long-term follow-up and support