The single anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) surgery is a modification of the traditional duodenal switch. The simplicity of the procedure, in comparison with DS, has caused an increasing interest among bariatric surgeons.Objective Evaluate the early outcomes of SADI-S. Setting: United States


The medical records of 187 patients who underwent a laparoscopic primary SADI-S procedure from April 2014 through December 2017 by two surgeons were retrospectively reviewed.


One hundred and eighty-seven patients were identified for analysis. The preoperative BMI was 54 +- 7.3 kg/m2. The short-term complication rate was 27.2%. During the first 30 days, 5.3% of patients required reoperation (Clavien-Dindo grade IIIb); however, one complication (.5%) was unique to the SADI-S procedure. The long-term complication rate was 11.2%. Of the three long-term grade IIIb complications that occurred, two (1%) were unique to the SADI-S procedure. The mean number of bowel movements per day was 1.7 +- 1.4, 2.1 +- 1.1, 2.2 +- 1.1, 2.5 +- 1.3, 2.9 +- 2.8, and 2.8 +- .6 at one week, one month, three months, six months, 12 months, and 24 months, respectively. The highest mode number of bowel movements per day through 24 months was three. The excess weight loss at 12 and 24 months was 76% +- 17% and 78% +- 15%, respectively. At two years, the ending BMI was 32 kg/m2. The mortality rate was 0%.


The laparoscopic SADI-S is an effective operation for achieving significant weight loss at two years.