SADI-S and Duodenal Switch Surgery in Tijuana

Duodenal switch surgery and its newer variant, SADI-S surgery, are two of the most effective bariatric procedures for super-obese patients struggling to lose massive amounts of excess weight. These bariatric procedures have restrictive and malabsorptive elements taken from gastric sleeve and RNY gastric bypass to promote significant weight loss and resolve obesity-related health problems like type II diabetes, high blood pressure, high cholesterol and other metabolic disorders. Undergoing one of these procedures in Tijuana, Mexico, is a safe and economical way to get back on the road to health.

Why Select SADI-S or Duodenal Switch Surgery?

The SADI-S procedure and duodenal switch surgery offer more significant modification of the intestines than Roux-en-Y bypass to allow for greater malabsorption, so patients absorb fewer calories from the food they consume.

Advantages and Disadvantages of Switch Surgery in Tijuana, Mexico

When compared with gastric sleeve or gastric bypass, SADI-S and duodenal switch, also known as BPD-DS, also offer a better chance of controlling diabetes, in addition to more significant weight loss. Duodenal switch patients also have a lower risk of developing ulcers than those who undergo gastric bypass.

Both procedures are more complex than other bariatric surgeries. The risk of intestinal obstruction, while rare, is higher than with sleeve gastrectomy but similar to gastric bypass. The malabsorptive component of these bariatric surgeries also have a higher risk of metabolic disorders, diarrhea, and nutrient deficiencies.

Understanding Duodenal Switch and SADI-S Surgery

To make an informed decision about which type of bariatric surgery is best for your needs, you should understand what each procedure involves. As with Roux-en-Y weight loss surgery, DS-BPD and SADI-S involve anastomoses. An anastomosis occurs when two pieces of the intestine or a section of the stomach and intestine are joined together. Duodeno-ileal refers to the two areas connected during weight loss surgery. The duodenum is the first part of the small intestine, while the lower portion is called the ileum.

How Does a Duodenal Switch Procedure Work?

Duodenal switch surgery developed as an improvement on a procedure called biliopancreatic diversion (BPD), which is why you may see this obesity surgery referred to as DS-BPD. The original surgery divided the patient's stomach in half horizontally and rerouted the digestive system. Because the amount of the small intestine bypassed was extremely long. Many patients suffered extreme malnutrition and dumping syndrome. Duodenal switch was developed to alleviate the adverse side effects of BPD.

Instead of sectioning off the stomach horizontally, duodenal switch surgery reduces the stomach by about 75%, shaping it into a slightly larger gastric sleeve. The smaller pouch limits stomach capacity, while intestinal rerouting is less severe to allow food to remain longer in the digestive tract. These modifications reduce dumping syndrome and malnutrition side effects.

Sometimes surgeons perform duodenal surgery in two separate steps when weight loss patients have an extremely high body mass index (BMI) to reduce the risks involved and shorten surgical time:

1. Gastric sleeve surgery to reduce stomach size and promote initial weight loss.
2. After two to three months, a second surgery alters the digestive system to reduce the amount of time ingested food stays in the body with fewer calories absorbed.

Duodenal switch bariatric surgery leads to dramatic weight loss and remission of many obesity-related health issues. However, because of its complexity and risks, doctors developed a modified variation called the Single Anastomosis Duodeno-ileal Bypass With Sleeve Gastrectomy, commonly called SADI-S.

How Does a SADI-S Surgery Work?

SADI-S is a further variation, also known as single-loop duodenal switch or Stomach

intestinal Pylorus Sparing (SIPS) surgery. Its purpose is to reduce other risks and complications DS-BPD presents through only one anastomosis. It's also less invasive than a bypass with sleeve gastrectomy or DS-BPD.

The modified duodenal switch (DS) with single anastomosis (SADI/SIPS) procedure involves creating a gastric sleeve that removes approximately 80% of the stomach. The malabsorptive portion reroutes a portion of the small intestine, creating two separate pathways and one common channel. The shorter digestive loop of the two pathways, allows food to flow from the stomach to the common channel. The longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel. This diversion limits the time that food mixes with digestive juices and reduces the number of calories a patient’s body absorbs, resulting in increased weight loss. Some patients may also have their gallbladder removed during this bariatric procedure, as many patients who lose significant amounts of excess weight require gallbladder removal at a future date to avoid gallstones.

Advantages of SADI-S Surgery

Traditional duodenal switch surgery bypasses a much larger portion of the small intestine, leading to persistent malabsorption of vitamins, minerals and even protein in some individuals. For a small percentage of patients, these deficiencies are only partially corrected using oral replacement supplements, leading to long-term difficulties. SADI-S preserves approximately 10 feet of the small intestine’s absorptive length instead of the two to five feet from duodenal switch weight loss surgery.

One of the biggest pluses of this bariatric procedure is that once healed, patients can eat “near normal” meals, albeit in smaller portions, than those who undergo a purely restrictive Roux-en-Y bypass, resulting in greater patient satisfaction. Because the small intestine is not divided into two segments in SADI-S, fewer complications occur, including the risk of leaking potentially harmful matter into the peritoneum or blockage is reduced. The possibility of intestinal entrapment in the space between the intestinal segments is also reduced. Fewer connections translate into a possibly shorter procedure, making it easier to perform in a single session while reducing the chance of hemorrhage and infection.

Preservation of the pylorus, the outlet of the stomach that allows food to pass into the small intestine for digestion, in SADI-S, one of the major benefits for weight loss surgery patients, is a significant benefit, as it prevents control of solid emptying while also preventing partially digested food and digestive juices from reentering the stomach.

Other advantages include:

• Faster recovery, with many patients returning to work a week after surgery
• Rapid weight loss with patients losing up to 40 lbs. in the first months and continuing to lose up to 90% of excess weight within six to eight months
• Regulates sugar levels
• Less hunger through the removal of the portion of the stomach that produces ghrelin, the hunger hormone

Advantages of Duodenal Switch Surgery

Approximately 99% of those with type 2 diabetes or high cholesterol, 92% with obstructive sleep apnea, and 83% with hypertension enter remission or are cured following bariatric surgery. Other conditions that can experience significant improvement or resolution include*:

• Asthma/breathing issues
• Dyslipidemia
• Arthritis
• Headaches and migraines
• Infertility/PCOS syndrome
• GERD and acid reflux
• Heart disease
• Back and joint pain

*According to DS Facts

Similarities Between Duodenal Switch Surgery and SADI-S

Both techniques are performed through laparoscopic surgery, but some weight loss patients may occasionally require open surgery for various reasons. This decision usually occurs during pre-op consultations. Surgeons can perform both operations in two stages, which is needed, to help patients with the highest body mass index achieve sufficient excess weight loss to make the second part of the procedure safer.

The risk of malnutrition remains present with both bariatric procedures, although the single anastomosis duodeno ileal bypass procedure lessens that risk. Patients must follow strict vitamin and mineral supplementation for the rest of their lives.

Shared Benefits

SADI-S and duodenal switch patients experience the following shared benefits:

• Dramatic long-term weight loss
• Feel full longer
• Portion control
• Less absorption of food

As patients lose weight, they will realize a significant decrease or resolution of obesity-related diseases, including obstructive sleep apnea, joint pain, etc.

Differences Between DS Surgery and SADI-S

The Y-shape connection in duodenal switch surgery prevents bile from getting into the

stomach, avoiding stomach discomfort and irritation. It also results in selective fat and nutrient absorption not present in SADI-S because of the multiple channels. The single ileal bypass with sleeve procedure (SIPS) has a reduced operating time of about 30 minutes and a reduced risk of post-surgical complications because of the single intestinal connection. SADI-S preserved approximately 10 feet of absorption in the intestines instead of two to five feet from traditional DS surgery.

Duodenal Switch Procedure Complications

Duodenal switch patients should remain aware that this weight loss procedure has drawbacks. As with any surgery, you can expect the following risks:

• Internal bleeding
• Infection
• Blood clots in your legs can move to the lungs
• Hernia
• Death

Because stomach size is reduced, certain foods can cause excessive gas that you may be unable to control. Additionally, patients must augment their diet with vitamins and minerals to prevent poor nutrition. If you follow a proper post-op diet and have realistic expectations, you can manage these potential disadvantages and achieve long-term weight loss.

Am I a Good Candidate for Duodenal Switch or SADI-S Surgery?

Duodenal switch surgery or SADI-S isn't for everyone. Your doctor may recommend one of these procedures if you have super morbid obesity and need to achieve excess weight loss greater than patients typically achieve with other surgeries. These weight loss surgeries are usually recommended only after attempting to lose weight by improving diet and exercise habits. You'll likely undergo an extensive screening process to see if you qualify. Qualifications include being willing to make permanent changes, including committing to a healthy diet before and after surgery to prevent weight regain. Another bariatric surgery may be more appropriate for some patients. Long-term plans involve monitoring your nutrition, lifestyle and behavior, and your medical conditions. You will also need to accept a lifelong need to change food choices, limit portions, and take vitamin supplements.

These surgical procedures are also performed to reduce your risk of potentially life-threatening metabolic diseases. They are particularly effective for diabetic patients to reduce the problems assisted with insulin-dependent type II diabetes.

Suited For:

To be a good candidate for SADI-S or DS surgery, you must have a BMI greater than 40 or a body mass index in the 35-39.9 range accompanied by hypertension, type 2 diabetes, sleep apnea, fatty liver disease or hyperlipidemia. Many prospective patients have a BMI higher than 50. Typically, you will be 100 pounds or more above your ideal weight.

Economical Weight Loss Surgery for Medical Tourists

Traveling to Mexico to undergo a bariatric surgical procedure gives patients more than excess weight loss. In the United States, most insurance policies do not cover bariatric surgery fees, so patients spend $20,000 to $30,000 for many procedures. When you come to Tijuana Bariatric Center, you'll spend a lot less while getting the dramatic results you want.

Consider Bariatric Surgery in Tijuana, Mexico

Dr. Fernando Garcia, our lead surgeon, specializes in treating patients struggling with extremely high BMIs who may have been refused treatment at other medical practices. He has performed thousands of complicated bariatric procedures, including DS surgery, SADI-S and other techniques that help patients safely lose excess weight. Our office in Tijuana, Mexico, limits the number of surgeries daily, so you get the highest pre-op, surgical, and post-op care.

Contact our office today at 800-970-0577 to set up a virtual consultation and begin a successful journey of losing weight once and for all.