Common Channel Length in Sadi-s

[JenKapNC]

I believe the explanation Dr. Enochs in Cary, NC gave me when explaining the SIPS/SADI was very informative and clearly presented the advantages/disadvantages. I believe this is correct... If I'm wrong, feel free to correct me on any of this...

• With SIPS/SADI you have one anastomosis. One connection were possible problems may occur. With the DS the bowel is divided in two places and there are two anastomoses.
• The SIPS/SADI is said to be an easier surgery to do vs. the DS. Therefore, more doctors may be qualified to perform this procedure in the future, whereas finding a truly qualified Dr. to perform the DS may take a little work.
• I believe the SADI uses a 250 CC and SIPS is standardized at 300 with a smaller sleeve. From what I've heard a "standard" CC with the DS is 100 unless the Dr. does a 40/60 split customized for the individual's bowel length. As others have pointed out, with the DS there is far less fat absorption, and obviously a greater absorption of carbs with SIPS given the length of the channel where the food and digestive issues mix. The nutritionist for the SIPS group (where I was) explained that SIPS patients need to monitor protein, carbs and fat. The trade off is that... (at least this is what I was told) along with a greater absorption of macronutrients there would be less vitamin deficiencies and therefore less risk of anemia, bone loss etc.

My two cents...

I think the SIPS may be worth considering if you're in the lower BMI ranges and have had some success with monitoring and controlling the quality of your diet. IMO I'm not sure the long term studies will prove that long-term weight loss with SIPS is as good as the DS, while I do believe there may be fewer vitamin deficiencies in the SIPS group.

My advice is to do your research and whatever procedure you decide to move forward with choose a doctor that is well-qualified to perform it.

 

[DSRIGGS]

Laura I think your point about risk is spot on. Any of these surgeries have risk but that risk is very minimal unless the patient has very serious health conditions going in to the procedure but even then the anesthesiologist and Surgeon know how to manage that risk.... And the way I look at the difference in risk between the procedures vs the potential outcomes is a 100% no brainer that says get the procedure with the best documented outcome.

That is why I chose the DS.

 

[Larra]

While it's true that there is one less anastomosis with the SADI, it's the easy anastomosis that you don't have. The tricky part, which is working on the duodenum, is the same with either operation. Any general surgeon, and not just bariatric surgeons, knows how to do a standard small bowel anastomosis. So yes, it's a bit quicker and easier, but not that much. And while there is less to go wrong, it's not common for the small bowel anastomosis to go wrong with the DS, so this is really a very small advantage.
Less work for the surgeon - true. A bit quicker to perform - true, but not that much. And if a surgeon is "qualified" to do a SADI, whatever that means, he/she would be equally qualified to do a DS, because again, the difficult portions of the operation are the same.
It will be interesting to see how the long term results turn out. I'm not impressed with the bit about less vitamin deficiencies because problems are really not common with the DS unless the patient is noncompliant (in which case the patient can definitely get into trouble, but the fault is the patient and not the operation). I do think the SADI is far, far preferable to gastric bypass, and will also be easier to revise to the DS if/when revision is needed, but I don't believe the results will equal those of the Ds.

 

[JenKapNC]

Agreed... which is why I'm leaving the practice that is pushing SIPS and going with a well-qualified DS surgeon... If I can get them to call me back and schedule my consult (sorry, venting).

 

[Larra]

Keep calling, @JenKapNC , and vent here as needed. Once you get into their system, hopefully things will go smoothly.

 

[southernlady]

I believe the SADI uses a 250 CC and SIPS is standardized at 300 with a smaller sleeve. From what I've heard a "standard" CC with the DS is 100 unless the Dr. does a 40/60 split customized for the individual's bowel length. As others have pointed out, with the DS there is far less fat absorption, and obviously a greater absorption of carbs with SIPS given the length of the channel where the food and digestive issues mix. The nutritionist for the SIPS group (where I was) explained that SIPS patients need to monitor protein, carbs and fat. The trade off is that... (at least this is what I was told) along with a greater absorption of macronutrients there would be less vitamin deficiencies and therefore less risk of anemia, bone loss etc.

Actually among DS'ers there is a great variance of common channel length. 100 SEEMS to be the most common unless the surgeon uses the Hess method.

My common channel is 175, my husband's is 125. I have had to have iron infusions and have osteoporosis. His iron is "to die for" and his bones are fine. BOTH of us need the same amount of iron since I am post menopausal. So I HONESTLY think that the surgeons are doing the SADI cause they don't want to admit that THEIR vitamin recommendations for the DS are horseshit!

I think the SIPS may be worth considering if you're in the lower BMI ranges and have had some success with monitoring and controlling the quality of your diet.

I'm about as LOW a BMI as you could get and still have WLS. My starting BMI was 35.2. There is a surgeon in Turkey who is doing the SADI and the DS. His criteria is based on BMI and COMORBIDS such as diabetes. If diabetic or even pre-diabetic, he recommends the DS over the SADI regardless of BMI.

 

[marissamast]

There will never be any long term study results if people don't step up and do the SADI - just as there weren't when the DS was considered very experimental. I thank GOD for you guys that are up to 20 years out for being the guinea pigs!!! That being said...I am not that brave to be a trail blazer.