The Traditional Duodenal Switch is the procedure with the best long-term results, especially for patients with metabolic issues. The Sadi-S, although similar, is a simpler version of the DS, but is only recommended in specific situations.

Both the Traditional DS, and the Sadi-S are mixed procedures, which means they have the restrictive and malabsorptive aspects and can be done as first-time surgeries or revisions (when a patient already has a previous weight loss surgery, like a sleeve or lap-band); but how are they different?

They differ in the second part of the procedure since the first part is the same, a gastric sleeve. A Biliopancreatic Diversion or Traditional Duodenal Switch has two anastomoses (connections made between tissues), creating a strict nutrient absorption that takes place in only 75 to 100 cm of intestine. The Hess method is used to determine the length of the limbs.

On the other hand, the Sadi-S, sometimes called a loop, has only one anastomosis and leaves a longer section of the intestine for absorption (about 300 cm) compared to the Traditional DS. To determine the length of the limbs the modified Hess method is used.

Our surgeons, after 12 years of performing the Traditional DS, primarily recommend it over the Sadi-S, except in certain cases. Here are a few specific scenarios when a Sadi-S is recommended over a full Duodenal Switch surgery:

  • When patients have a really high BMI (over 50), which means their intestines are heavier and might tear in the anastomosis, due to their weight.
  • When it’s being performed as revision surgery and there isn’t a lot of weight to be lost, the Sadi-S is a lighter approach.
  • When it’s a first-time surgery and the patient doesn’t have a high BMI but has conditions that can be improved with the metabolic effect of the Sadi-S (like type 2 diabetes).
  • Smokers, given that the anastomoses don’t manage to heal properly, because of the weakened immune system. Less connections = safer surgery.

The weight loss results are alike, but the full Switch is considerably a more complex surgery. For this reason, it is currently only done by 3% of bariatric surgeons in the USA. At Mexicali Bariatric Center 30% of our surgeries are Switches, both the Traditional Duodenal Switch, as well as the Sadi-S.

If you are considering a Duodenal Switch or a Sadi-S as a first procedure or a revision surgery, we are happy to assist and provide any information to determine the best option for you. Please contact us at (888) 344 3916 US Toll-Free or www.mexicalibariatric.com