Amy, I don't know if pioneer would be the correct term. I'm a smudge over 5 years out with the Sadi. I will say that I have for the most part maintained my weight loss, Height 5'6" HW ~350 CW (well 165 -175) like 10 pounds more than I want to be but it's that I really like real Cokes and when I stop that the weight comes off. When I dropped below 150 I started back on coke to maintain my weight and never stopped. Would I go for the original DS if I had another chance, Hell yes. Have I had side effects from the surgery, I've had a few odd things but nothing that sent me into a hospital room or a docs office that the original wouldn't have as well. It's the peace of mind, it's not having the long term stats of success. It's not knowing if I will develop bile reflux eventually. Anyone can have side effects but if you are going to be cut on, go with what has been proven, the real DS. I eat what I want for the most part now, my milk intolerance has become a lot better and won't send me running to the bathroom anymore. Getting 150 grams of protein a day is very very easy. I don't pay attention to carbs but I don't have a taste anymore for the really good(bad) stuff and fruit must be in moderation or I have to stay home the next day for the after effects. My comorbidities except for Afib are gone. My Gerd is back but it's not bad at all. Saying all that, if I could do it over, I would choose the piece of mind. The only benefit I can see with the SADI is that it takes the surgeon less time and causes me to wonder if the surgery will last. I also due to personal travel issues, didn't use a vetted surgeon. I think my surgeon was good but if you can, go vetted.
SADI-S / Loop - Please share facts about this new procedure here.
- Thread starter hilary1617
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I say Pioneer because my gastric sleeve was 5 years ago. I just had the SADI LOOP 2 months ago. So, it was a two stage procedure for me which is what my surgeon said is new. I feel this is going much slower, but I have to remember that I was only eating 800 calories five years ago and now I'm eating 1800 and seeing results. Normal weight loss results. I won't be the people that lose 50 lbs in three months for sure, but as long as it keeps trending downwards, I'm ok.
hilary1617
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Hi @Amy S . Congratulations on the success of your recent procedure and your weight loss! If I may, was your 2nd part / revision / from VSG to SADI conducted as an outpatient or inpatient? I saw someone post earlier in this thread that a revision from SADI to DS could be done outpatient and I'm wondering if that is also the case for revision from VSG to SADI. How are you feeling? I hope well. Best wishes!
My surgery was at 7a and I was released the next day at 5p. Only had to wait bc had my leak test in the morning and the surgeon does surgery all day and could not leave until he saw me. Out-patient does not sound do-able to me?? I feel really good, this was much easier than the VSG.
hilary1617
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Glad you are doing well and one night isn't bad! Please remember to stay hydrated and to keep that protein going.
I get it. Thanks. I'm pretty sure with two stage operations, it does go slower. Not positive but I think that's normal. I can't believe you survived insurance approval twice...once was enough for me LOL This is not a race to the finish, this is progression to health and well being. This is a process, a long one. I still turn sideways going through doors sometimes and try to push a stomach I don't have past the steering wheel when I get in the car. Be good to yourself, don't count calories, watch carbs and keep your protein and fats high and you'll do fine
hilary1617
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I get it. Thanks. I'm pretty sure with two stage operations, it does go slower. Not positive but I think that's normal. I can't believe you survived insurance approval twice...once was enough for me LOL This is not a race to the finish, this is progression to health and well being. This is a process, a long one. I still turn sideways going through doors sometimes and try to push a stomach I don't have past the steering wheel when I get in the car. Be good to yourself, don't count calories, watch carbs and keep your protein and fats high and you'll do fine
Hi @MyNewLife, Glad you are doing well! I echo your sentiment with the exception that Amy, as a SADI/SIPS/Loop DS patient, will need to follow a low fat diet (and low carb diet) in order to maintain weight loss over the long term given the SADI does not provide for the selective fat malabsorption provided by the traditional DS.
hilary1617
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Hi Hilary,
My toilet would argue that fact
@MyNewLife, Though it's a bit odd to say, it, cheers for your buoyant output! That's great to hear.
Gunner2014
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Where is your surgeon located? Houston has very few who do the SADI.
I'm coming late to this party, but on the original question of whether there were studies, in April 2017, French Drs Tolbert and Becouran published an analysis of all the published outcomes of SADI. .http://dx.doi.org/10.1016/j.soard.2017.04.027
This is their conclusion: "There are still limited long-term data available for single anastomosis duodenal switch. In the absence of published prospective randomized trials, no evidence exists in favor of this variant of the BPD-DS despite a possible trend in less malabsorption side effects." They also reported a 7% revision rate at 5 years.
Some people succeed no matter what surgery they pick. The questions are what is the likelihood of succeeding, how hard weight loss is to maintain, what are the effects on obesity comorbidities, and what the side effects are. Given the right and complete information, some people may rationally choose SADI for themselves. My concern is that surgeons do not adequately explain what surgery they are doing, they've selected a name for the surgery that makes it easy to fool patients into thinking they are getting a traditional DS, and no one knows the long term effects yet. Patients should learn these facts in no uncertain terms before they make the choice.
When I selected my standard Hess DS, it was a variation on the older bypass procedure that had some devastating side effects for some people. There were data about DS in 2005, but much less than about RNY. This surgery was explained to me in full detail and I was a full participant in my decision to have the DS. I only had to choose between RNY and DS, so it was easier.
Here is more from the abstract about SADI:
The single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was designed in 2007 to reduce the side effects of biliopancreatic diversion with duodenal switch (BPD-DS) by replacing the Roux-en-Y construction with a single duodeno-ileal anastomosis and combining the common channel with the alimentary limb. Several variants using different channel lengths were published. The objective of this study was to identify the published cases of SADI-S and variants and assess the results regarding potential benefits on side effects and revisions
In all, 19 studies were analyzed. After identifying overlaps, 1,041 patients among 9 institutions were identified: 304 with SADI-S, 667 with stomach intestinal pylorus sparing surgery, and 70 with single anastomosis duodenojejunal bypass with sleeve gastrectomy. There were no postoperative deaths and the early complication rate was 7.3% (range 1.6–14%)... The mean 1-year percentage of excess weight loss (%EWL) was 78.7% (range 61.6–87%) and percentage of total weight loss (%TWL) was 36.8% (range 32.7–41.1%). Two studies reported a 2-year %TWL of 38.7% and a single study reported a 5-year %TWL of 37%...
One retrospective study found no difference between BPD-DS and SIPS for vitamin deficiency at 2 years, but there was less severe diarrhea and malnutrition after SIPS. The revision rate increased from 2% to 7% after SADI-S between 2- and 5-year follow-up.
This is their conclusion: "There are still limited long-term data available for single anastomosis duodenal switch. In the absence of published prospective randomized trials, no evidence exists in favor of this variant of the BPD-DS despite a possible trend in less malabsorption side effects." They also reported a 7% revision rate at 5 years.
Some people succeed no matter what surgery they pick. The questions are what is the likelihood of succeeding, how hard weight loss is to maintain, what are the effects on obesity comorbidities, and what the side effects are. Given the right and complete information, some people may rationally choose SADI for themselves. My concern is that surgeons do not adequately explain what surgery they are doing, they've selected a name for the surgery that makes it easy to fool patients into thinking they are getting a traditional DS, and no one knows the long term effects yet. Patients should learn these facts in no uncertain terms before they make the choice.
When I selected my standard Hess DS, it was a variation on the older bypass procedure that had some devastating side effects for some people. There were data about DS in 2005, but much less than about RNY. This surgery was explained to me in full detail and I was a full participant in my decision to have the DS. I only had to choose between RNY and DS, so it was easier.
Here is more from the abstract about SADI:
The single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was designed in 2007 to reduce the side effects of biliopancreatic diversion with duodenal switch (BPD-DS) by replacing the Roux-en-Y construction with a single duodeno-ileal anastomosis and combining the common channel with the alimentary limb. Several variants using different channel lengths were published. The objective of this study was to identify the published cases of SADI-S and variants and assess the results regarding potential benefits on side effects and revisions
In all, 19 studies were analyzed. After identifying overlaps, 1,041 patients among 9 institutions were identified: 304 with SADI-S, 667 with stomach intestinal pylorus sparing surgery, and 70 with single anastomosis duodenojejunal bypass with sleeve gastrectomy. There were no postoperative deaths and the early complication rate was 7.3% (range 1.6–14%)... The mean 1-year percentage of excess weight loss (%EWL) was 78.7% (range 61.6–87%) and percentage of total weight loss (%TWL) was 36.8% (range 32.7–41.1%). Two studies reported a 2-year %TWL of 38.7% and a single study reported a 5-year %TWL of 37%...
One retrospective study found no difference between BPD-DS and SIPS for vitamin deficiency at 2 years, but there was less severe diarrhea and malnutrition after SIPS. The revision rate increased from 2% to 7% after SADI-S between 2- and 5-year follow-up.
Can you message me some places where I can talk to more people who had done the loop?
hilary1617
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Hi @Ellie Mae, Here! Given it is a relatively new procedure, there aren't as many patients out there who have had SADI/SIPS/Loop - that's why I started this thread - in the hope that those patients could connect and share their experiences.
I don't understand. Where?
Can you send it to my inbox?
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