Anyone had the SADi-S (Single anastomosis duodeno-ileal bypass with sleeve gastrectomy)

I was at Rex, as well. It was sort of a strange experience because I actually work for Rex, but I am based at UNC Chapel Hill. I know most of the nursing and case management teams because I have filled in at Rex periodically. People would see me and look very confused because I was the patient instead of the On Site Home Service Liaison. I kind of had fun with it, even though my total of three weeks inpatient were pretty miserable.😜

I know - I felt the same way at first......like it was a little bit of "attack mode" when I mentioned the loop DS. Just know that people are defensive of the procedure that they had that has helped them in so many ways BUT..........BUT that does NOT mean they "OWN" the term DS or the name or what have you. They are just people. Giving their opinion. Take what they have to say and sift out the negative vibes....they do have good advice on nutrition and vitamins etc etc.

My only wish is that your doctor had told you up front more of the difference between the two procedures. Also, keep in mind as they call us "guinea pigs" that Dr. Hess' initial patients were too....taking a risk on a new procedure. I've often wondered if they were to read these comments feel some angst as these people are in essence calling them "stupid" to have done something so new and without long term data. Seems they should have more respect!!!

I had the SADI-S with Drs. Ungson and Beltran on November 14 in Mexicali.  Just got home last night and I'm doing great!

Dr. Ungson is considered to be one of the premier DS surgeons in North America (having performed more than any other surgeon and with a significantly lower complication rate) and I chose going to him self pay over waiting for an insurance covered procedure next year with Dr. Kim in Dallas.  (Dr. Kim would actually only do the DS as a sleeve revision for me anyway meaning 2 potential surgeries with then exponentially increased risks - which I was trying to minimize.)  While Dr. Kim seemed hesitant, Dr. Ungson was confident.  Don't get me wrong - Dr. Kim is a great doctor and I like him.  But for the DS or SADI-S (which is not offered) he wasn't a viable option for this reason.  

The absolute #1 reason I took this option is the significant reduction of inter-operative and post-operative complications.

Originally, I had planned on the DS and only switched my decision to SADI-S on the day of surgery after discussion with the doctors. The whole diminished surgical risk issue trumped everything for me as I was very nervous about complications having just gotten off of a whole day reading here on OH about some bad recent experiences for folks!  The idea about it being new or experimental didn't bother me after researching in a quick few minutes those are highly exaggerated claims with the SADI-S - it has been around long enough with GREAT short and mid term results but not so long that far range data can be had.  Dr. Ungson (and remember his reputation) seemed TRULY impressed with this as the better option overall, so him being the expert, I relied on his experienced advice.  

However, I do wish I did my detailed homework beforehand (never even having heard of it before surgery day) so I was better prepared to weigh the other pros and cons.  Now I have done a ton of homework now and have had extensive discussion with the docs and reading the studies and pouring over and over the anatomical differences (which I'll try to link in a subsequent post)

Here's the conclusion I have drawn between the two procedure in a nutshell:

DS -  If you want a fail safe, proven, guaranteed to loose weight with very few lifestyles changes except lifelong vitamin usage, do the DS.  Know at some point or another you WILL have malnutrition challenges, although most can be handled with proper supervision.  You will have to over eat your protein forever - a bonus to some!  You will not have to watch your fat intake or focus on lifestyle change as severely as with other WLS options but no surgery is ever going to be a free for all.  Your co-morbidities have an excellent chance of being resolved.  It is a great option for those who want the tried and true, no surprises route.

SADI-S - Less operative risk.  BAM.  Less complication rate.  BAM.  However, more lifestyle changes required, especially in the long term - you cannot be as liberal with fats or sugars but within reason (read i.e. like a normal person ;o so the sleeve part will help with that) you should still experience great to excellent results.  Your common channel will be SIGNIFICANTLY longer (double to even triple the DS) but overall still a little less than half of what you were before surgery so you'll get plenty of mal-absorption.  While you still have to be on a supplementation regime for the rest of your life, your likelihood of future malnutrition issues (even with lax adherence) is smaller.  Your co-morbidities also have an excellent (if not slightly statistically better but the jury is still out) chance of resolution.  Additionally, IMHO, if you, like myself, have a serious risk of future health issues (for me cancer and heart due to familial genetics is a big possibility) this is a huge, huge advantage.  You will absolutely have to focus on your food choices and the associated emotional factors more so than with a DS to maintain your weight loss but come on - should we as former fatties want to do and have to do that anyway regardless of surgery type?

So here's my deal and I mean no disrespect to anyone's choice.  There are a ton a reasons I'm fat.  Because of that, regardless of what surgery I have I am going to take my potential of regain seriously.  So it should seem like DS is the best solution out of the park.  So why did I choose differently and why do I remain confident it was the best choice?  Because SADI-S takes into account my whole health outlook (complications, malnutrition, possible future disease (genetic cancer and heart risk) not just my weight while offering similar results.  While the longer common channel (3 meters in my case) is scary and somewhat disappointing, it actually fits my future health risk profile more completely than a DS will.   And since my BMI (53) was too high to reasonably consider just a sleeve as a complete mitigation, it seems it was my best option.

Thank you for posting. Sounds like you weighed all the options and the pros and cons and made an intelligent decision. Good for you!

Did Dr. Ungson explain why he makes the common channel longer than the norm? The standard for the Sadi seems to be 250cm.

i corresponded with Dr. Pernaute who created the Sadi and he said he did the first few at 200cm then started doing them at 250.

A lot was based on my pre surgery self reporting so you have to be honest about it.  I was a healthy eater but ate a TON of food.  My only real vice was coke every once a day.  No real problem with candy or outrageous carbs.  The sleeve will help with amounts and for me the best working part of the surgery.

But my BMI is high - 51- so I need a little extra kick of help. 

I recall he feels that for people with a 6 meter or less intestine the best practice is to divide the intestine evenly at a specific point. For longer than average intestines I believe he does something different.  But mine was the average 6.

I was told this was the best balance of all my issues - concerns about future malnutrition and still a decent approach to my obvious hyper-efficient absorption.  Enough intestine to get my vitamins assimilated with even lax supplementation and yet enough removed from the digestion equation to decrease my absorption by half.  

With proper diet this should do the trick.  They stressed that again and again - I will not have the same super advantage of the traditional DS but I will also not have some of the same problems.  Since I was a healthy eater anyway but just large volumes, they do not foresee a significant disadvantage.  

If I had serious concerns with my ability to maintain a healthy diet (only cheating every once and a while) this would have been a bad option for me. He stressed that.  The sleeve part will help with the AMOUNT of healthy food I am used to eating and the 300 channel will help to the rid of enough calories to give me the boost of malabsorption without TOO much.      

I have been reading and one of the concerns with too small common channels is the tendency for the channel surface to become hyper efficient again (absorbing more and more calories) while still not conquering the malnutrition.  If you have a tendency to eat junk (no judgement just reality) then the problem will be exacerbated.

If you have legitimate, serious concerns about heaving a good diet post surgery, I really do not think the SADI-S is for you.  I just happen to like the type of food that will make it successful.  Not everyone does and I would hate to see someone convince themselves they can complete change who they are.  It is OK to be honest and real.  If you feel fat and sugar will always be little devils on your shoulder go for the traditional DS.

We will all have to change our diet and mindset post surgery - this is true.  But also take into account your possible shortfalls in the future.  It's unrealistic to expect you will be a completely different emotional person.  The only thing that changes completely is your dress size - the rest is a process.

Both are good operations and I think between the two they represent the best of all the options out there but that's a personal opinion.  So you have to figure out whole picture which will work best for you.  You are not better or worse for it being one or the other.  This arguing I see here on this board about it is meaningless.  

What an EXCELLENT explanation. I'm not sure if you are still around on the boards, I tried to search you and it said you were either private or gone. If you're still around, please send me a private message.  It looks like I'll be getting the SADI done in May. I'm excited and scared, but it's what I need to do. Sometimes it's hard to find support on about any board, being that some of pretty vehemently opposed to the SADI.

Yvonne

Hi! I had this procedure on 12/3/13. HW 268 and I am 116 pounds. I had to meet with my surgeon in August inorder to stabilize my weight because I kept losing . Since August a few pounds but nothing drastic. I never thought I would be able to fit into a size 2/4 and x~small pants and x~small /small shirt.  I am grateful when my surgeon suggested this procedure and I agreed.  My weight mainly effected my blood pressure. Surgeon suggested this procedure because I wasn't a severe diabetic. My A1C , levels were increasing but that was it. I am pleased with the procedure so far. My CC is 150. All the best!

Mel, I'm not convinced you actually had the Sadi-s. I've never heard of a Sadi with such a short cc. Even Dr. Pernaute who created the Sadi started out doing a 200cm cc and then changed to doing them 250cm. 

Your cc is much more in line with the traditional DS.

Congratulations on your loss! You've done exceptionally well! 

Hi. Is the SADI also called a single loop DS. Dr Roslin in nyc promotes this surgery unless you are a severe diabetic. Im glad I listened to him. Im pleased with the surgery. 

I had the Single Loop DS 13 days ago, and I'm feeling really good. No complications, down 20lbs, starting to eat normal food which seems to help accelerate the healing process. I could take 6 weeks off if I wanted but I ready to go back now.