SADI-S Procedure (Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy)

SADI-S surgery is considered one of the most powerful modern bariatric procedures. It has proven to be an effective solution not only for weight loss, but also for treating many obesity-related conditions such as type 2 diabetes, high blood pressure, and sleep apnea.

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When this procedure is performed at a specialized center such as Matar Clinic under the supervision of Professor Dr. Mohamed Matar, it becomes a real opportunity to restore and reset your health after traditional attempts have failed, or even after previous bariatric surgeries that did not achieve the desired results.

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What Is SADI-S Surgery?

SADI-S surgery is an advanced bariatric procedure that combines sleeve gastrectomy and gastric bypass in a single step, with the aim of achieving significant and sustained weight loss along with substantial improvement in obesity-related conditions.

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The procedure may be performed as a primary surgery for patients with severe obesity, or as a revisional surgery for patients who did not achieve successful results with sleeve gastrectomy or certain other bariatric procedures, regained a significant portion of their weight, or continued to experience health problems.

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Studies show that SADI-S achieves significant and sustained long-term weight loss, with high rates of improvement or near-complete remission of diabetes, high blood pressure, and obesity-related sleep disorders.

​Read also: My Experience with Sleeve Gastrectomy

How Is SADI-S Surgery Performed?

The procedure is performed laparoscopically through small incisions in the abdomen, which reduces pain and hospital stay and accelerates recovery.

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The surgery aims to combine restriction of food intake (by reducing the size of the stomach) with reduced absorption (by altering the pathway of part of the intestine), through two main steps:

First Step: Sleeve Gastrectomy

Approximately 75–80% of the stomach is removed, transforming it into a narrow tube resembling a banana (the same concept as sleeve gastrectomy).

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This significantly reduces the size of the stomach, so the patient consumes much smaller amounts of food, while hunger hormones decrease and the feeling of fullness improves.

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Second Step: Duodenal Switch

After the sleeve gastrectomy, the surgeon creates a connection between the first part of the small intestine (the duodenum) and a more distal section of the intestine at a specific distance, allowing food to bypass a significant portion of the small intestine.

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As a result of this connection, food does not pass through the bypassed section of the intestine, significantly reducing the absorption of calories, fats, and sugars, which strongly supports weight loss.

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In this way, SADI-S surgery combines the power of sleeve gastrectomy in controlling appetite with the effectiveness of intestinal bypass in reducing absorption, but with a more modern design and only one anastomosis, making it less complex than traditional bypass procedures.

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How Does SADI-S Help With Weight Loss?

The procedure promotes weight loss through two main mechanisms:

Reducing Food Intake

Removing 75–80% of the stomach significantly reduces its capacity, so the patient is no longer able to consume large amounts in a single meal, while experiencing a rapid feeling of fullness and satiety.

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Reducing Food Absorption

Bypassing more than half of the length of the intestine causes a large portion of food to pass without being fully absorbed, reducing the absorption of fats and calories and making it more difficult for the body to store them as excess fat as it did before surgery.

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This combination makes SADI-S one of the most powerful procedures for achieving substantial and sustained weight loss, particularly in cases of severe obesity or after other procedures have failed.

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What Are the Benefits of SADI-S Surgery?

Clinical experience and studies indicate several important benefits of this procedure:

​Management of Type 2 Diabetes

SADI-S is considered one of the most effective procedures for improving or even achieving long-term remission of type 2 diabetes, thanks to its effects on intestinal hormones and metabolism, as well as reduced sugar absorption.

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Treatment of High Blood Pressure and Improvement of Cardiovascular Health

Weight loss, reduced insulin resistance, and lower fat levels help lower blood pressure and improve heart and blood vessel health.

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Significant Improvement in Sleep Apnea

Weight loss reduces pressure on the airway, which helps improve or eliminate episodes of sleep apnea and enhances sleep quality and energy levels throughout the day.

Loss of a Large Percentage of Excess Weight (Up to 75–80%)

Patients may lose an average of 75–80% of their excess weight during the first two years, making it one of the most effective bariatric procedures in terms of weight loss.

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Reduced Appetite and Better Control of Food Intake

The sleeve gastrectomy performed at the beginning of the procedure reduces hunger hormones, while the bypass reduces the desire to eat excessively, helping establish healthier eating habits.

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Reducing the Risk of Dumping Syndrome

Because the gastric valve (pyloric sphincter) is preserved in SADI-S, the likelihood of dumping syndrome is lower compared with traditional gastric bypass, which improves the patient’s comfort after eating.

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Reducing Bile Reflux and Acid Reflux in Many Cases

The modern design of the procedure reduces some bile reflux problems compared with certain older procedures when the appropriate patient is selected and the anastomosis is properly constructed.

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What Are the Disadvantages and Risks of SADI-S Surgery?

Like any major bariatric surgery, SADI-S surgery has certain disadvantages and challenges that should be understood before making a decision.

• Malabsorption and Vitamin and Mineral Deficiencies

Because a large portion of the intestine is bypassed, the patient has a greater need to take vitamins and minerals (such as iron, vitamin B12, calcium, vitamin D, and others) regularly and undergo periodic laboratory tests. Therefore, Professor Dr. Mohamed Matar emphasizes strict adherence to the prescribed diet and supplements after surgery.

• Risk of Leakage (at a Low Rate)

As with any sleeve gastrectomy or bypass procedure, there is a small possibility of leakage from the stomach or anastomosis. The rate is often around 1% or less at experienced centers, highlighting the importance of choosing an experienced bariatric surgeon and a qualified center such as Matar Clinic.

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• Risk of Blood Clots

Bariatric surgery carries a relative risk of developing venous blood clots. This risk can be reduced through early movement after surgery, using the blood-thinning injections prescribed by the doctor, and following preventive instructions carefully.

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Adhering to Matar Clinic’s pre-operative preparation program and post-operative follow-up approach reduces these risks and ensures that the benefits of the procedure outweigh any potential complications.

Read also: Best Sleeve Gastrectomy Surgeon in Egypt​

What Happens After SADI-S Surgery?

The post-operative period is a crucial part of the success of SADI-S, and at Matar Clinic, it is carefully organized:

1- Hospital Stay

The hospital stay usually ranges from one to two days after surgery to monitor the patient’s condition, control pain, and ensure stable vital signs.

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2- Speed of Recovery

Because the procedure is performed laparoscopically, recovery is faster compared with open surgery. The patient can begin early movement under the supervision of the medical team.

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3- Pain After Surgery

Pain is usually mild to moderate and can be controlled using a patient-controlled analgesia (PCA) device, along with pain medications adjusted according to each patient’s needs.

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4- Follow-Up at Matar Clinic

A follow-up appointment is scheduled approximately one week later with Professor Dr. Mohamed Matar to examine the wound, assess food intake, review laboratory tests, and adjust medications and supplements.

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5- Diet and Physical Activity

Adherence to the “approved diet after bariatric surgery” at Matar Clinic, which begins with liquids, followed by soft foods and then solid foods gradually, with a clear focus on protein and avoiding sugars.

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6- Continuing the Prescribed Vitamins and Supplements Regularly.

Do not neglect appropriate exercise after recovery (such as walking and then gradually increasing activity), according to the doctor’s recommendations, to ensure the best weight-loss results and improve overall health.

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Could SADI-S Surgery Be Your Second Chance?

If you suffer from severe obesity accompanied by diabetes, high blood pressure, or sleep problems, or if you have previously undergone sleeve gastrectomy or another bariatric procedure without achieving the results you hoped for, SADI-S surgery may be your second chance to restore your health and improve your life.

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Contact Matar Clinic now to schedule a consultation with Professor Dr. Mohamed Matar to determine whether SADI-S is suitable for your condition and learn about the weight-loss plan, follow-up program, and post-operative diet, within a safe and specialized medical framework that cares about every detail of your journey from beginning to end.