Common Channel Length in Sadi-s

[star0210]

So out of curiosity, I asked Nina with Dr. Ungson how long he makes the common channel for the Sadi-s and she said he does them at 300cm or if the intestine is longer than 7m then he makes them 40% of the total length.

Just info to have.

 

[bearmom]

Didn't know Ungson was doing those. If so, I just lost some respect for him.

If that's the case, I'd just get a sleeve.

 

[star0210]

He does both...the traditional DS and the Sadi-s.
I don't know why that would make you lose respect for him.
He's not giving people a Sadi without their knowledge.

 

[Spiky Bugger]

He does both...the traditional DS and the Sadi-s.
I don't know why that would make you lose respect for him.
He's not giving people a Sadi without their knowledge.

Is he mentioning that it is an experimental procedure with no documented track record?

 

[brooklyngirl]

Ok, I'm playing devil's advocate because I'm getting quite curious... I've been reading about the SADI more and more over the past few months, and, recently, about some very well-respected surgeons performing, or even preferring, to do the SADI. So, I see that some people are (understandably) upset when a doctor doesn't explain what he/she is REALLY doing and the patient walks out thinking they have DS anatomy when they don't, I believe that's unethical, but if there's fully informed consent, what is so wrong? Now, again, I'm playing devil's advocate because I'm not fully informed on the subject, I tried to google what exactly qualifies something as an experimental procedure, but I'm not getting a clear cut answer.

 

[star0210]

I agree...if a patient understand and chooses the Sadi...then no problem. They have every right to make that choice.
But when a patient walks in and says I want a DS and the doctor casually mentions a single loop or uses other language that most people who haven't done exhaustive research would understand then to me that's criminal.
I think it is incumbent on the doctors to be very clear and explicit about it.

 

[Spiky Bugger]

Good question, @brooklyngirl , for which I have no definitive answer and I am sure there is one.

However, close enough for me, is the fact that the ASMBS doesn't even mention it as a Bariatric Surgery on their website:

https://asmbs.org/patients/bariatric-surgery-procedures

If I weren't so lazy I'd try for a real answer...lol! Sorry

 

[star0210]

Is he mentioning that it is an experimental procedure with no documented track record?

I don't believe most surgeons are viewing it as experimental anymore, but on the website they DO say that there are still no long term studies.
http://sadi-s-surgery-in-mexico.blogspot.mx

 

[DianaCox]

No long term studies.
No long term studies.
No long term studies.
No long term studies.

The part of the DS that is mostly involved in weight loss is the sleeve. Both a proper DS and the SADI have sleeves. But the part of the DS that keeps the weight off is the switch. The SADI does not have the same selective malabsorptive benefits as the switch, and there is about 2.5 times (250%) more intestinal absorption possible, especially for fat. In fact, with 2.5 times longer for contact of the fat with the bile, there could be even MORE than 250% more fat absorption, since emulsification of the fat by the bile (and the extra length of intestine for motility that helps break down the fat into emulsion droplets) so the lipases can do their work may be the rate limiting step: http://courses.washington.edu/conj/bess/fats/fats.html.

I'm still not seeing any reason to believe the SADI could induce MORE weight loss - none.

 

[bearmom]

I don't believe most surgeons are viewing it as experimental anymore, but on the website they DO say that there are still no long term studies.
http://sadi-s-surgery-in-mexico.blogspot.mx

Not based on anything I've seen yet. And the page you linked, is just a surgeons sales pitch, nothing relating to any studies or data, unless of course you mean ;

"While still having the advantages of the duodenal switch:

• Highest % of excess weight loss of all weight loss surgeries
• Highest % of long term weight loss maintenance of all weight loss surgeries
• High rate of malabsorption"

Studies HAVE shown that with DS, but this makes it appear as if they are saying this applies to SADI. No such data to back that up.

I would like there to be a new miracle WLS, but the unfounded claims, and SADI recipients I've seen lately that seem to be clueless as to what their surgery was / wasn't, is very reminiscent of the BS claims that all the lap band surgeons were touting a few short years ago.

 

[star0210]

Not based on anything I've seen yet. And the page you linked, is just a surgeons sales pitch, nothing relating to any studies or data, unless of course you mean ;

"While still having the advantages of the duodenal switch:

• Highest % of excess weight loss of all weight loss surgeries
• Highest % of long term weight loss maintenance of all weight loss surgeries
• High rate of malabsorption"

Studies HAVE shown that with DS, but this makes it appear as if they are saying this applies to SADI. No such data to back that up.

I would like there to be a new miracle WLS, but the unfounded claims, and SADI recipients I've seen lately that seem to be clueless as to what their surgery was / wasn't, is very reminiscent of the BS claims that all the lap band surgeons were touting a few short years ago.

I was replying to Spiky asking whether Dr. Ungson was mentioning that it's an experimental procedure with no documented track record.

 

[star0210]

@DianaCox

This is what I wrote to Dr. Pernaute....I posted his response in a separate thread.

In the most simple of terms this is my understanding of the difference between the two procedures.
In the traditional DS, food and the digestive “juices” don’t mix until they reach the common channel.
In the Sadi-s, food and digestive “juices” are mixed the whole length of the common channel.
Using average numbers:
Traditional DS: 150cm alimentary limb – food only
100cm common channel – food and digestive juices together
Sadi-s: 250cm common channel – food and digestive juices together
Is this correct? If so, the question to me is how much MORE absorption takes place in that 150cm in the Sadi-s where food is mixed with digestive juices as compared to that same 150cm in the traditional DS where there is JUST food.
What effect does that have on complex carb absorption?

 

[Sheanie]

Jesus, now Ungson? I'm losing respect for these bariatric surgeons. If the SADI had the same exact malabsorption as the DS, it wouldn't be called the SADI.

 

[star0210]

Jesus, now Ungson? I'm losing respect for these bariatric surgeons. If the SADI had the same exact malabsorption as the DS, it wouldn't be called the SADI.

When I asked Nina (Dr Ungson's coordinator) about the Sadi a while back this was her response...

The Sadi-s does have a lower risk of complications for sure and the dr has been having very good results with is. You do have less malabsorption with the Sadi- s, I think it is a good option since your BMI is not very high but you can discuss this with Dr Ungson with him when you are here.

 

[DianaCox]

It isn't weight loss that matters, it is MAINTENANCE of weight loss that matters. And that's malabsorption. And SADI doesn't have nearly the same malabsorption.

I eat far more than I did when I was morbidly obese. But I eat more often - the sleeve is NOT stopping me from eating a lot over a 24 hr period anymore, even though it keeps me from eating as much at one sitting. I'd be near 300 lbs again if not more without the malabsorption.