I reached out to Dr. Sánchez Pernaute, the surgeon who invented the SADI , and with his permission have attached a note from him below. He has also graciously provided his email address,
[email protected] , should anyone wish to contact him with questions.
Dear Hilary,
I started doing SADI-S more than 7 years ago. I had performed standard DS since the late '90s; DS was a difficult surgery to perform, and in the early 2000s very few surgeons in the world attempted to complete a laparoscopic DS. After many lap-DS I was trying to simplify the technique and came aware that when you are preserving the pylorus there is no need to perform a Roux-en-Y diversion, which is mostly build up to elude alkaline reflux; if the pylorus, the natural barrier for biliary reflux, was left intact, there was no need to perform this Roux-en-Y to complete the switch. The only problem that I had was to decide the adequate limb lengths, as it was very easy for a three-limb operation, but there was not a great experience in a one-loop reconstruction. I initiated a prospective trial, accepted by the Ethics Committee of my institution, in which I completed SADI-S with a 200 cm common (and alimentary) limb. Patients did great, but I had to re-operate 4 cases for undernutrition. Perhaps they were not properly selected or perhaps the operation was too aggressive. I changed the common loop length to 250 to get a safer operation. Since then I have operated almost 150 patients more, for a total of almost 200 patients submitted to SADI-S; fifty patients have now more than 5 years follow-up.
Results are very good in weight loss, and these have been publisher in Obesity Surgery, SOARD, and presented at the ASMBS Annual Meeting, and the IFSO world Congress. The operation has been performed live for the New York Sleeve Gastrectomy Meeting (2012) and to IFSO World Congress 2014 just today. Results on diabetes will be presented in November at the Obesity Week in Boston.
Results in the mid and long-term are equal to those obtained with traditional DS through a much simpler operation. Every patient submitted to SADI-S must feel safe, as the rate of complications is lower than after a DS with the same, or even better, weight and metabolic results (there is a higher bile acid exposure to the intestinal cells, and this has demonstrated an important incretin function, with improvement of the beta-cell pancreatic function). Biliary reflux was carefully studied in the first series of patients, and results were similar to the controls in the normal population.
You, and the patients in the forum can write me and ask me whatever you want.
Thank you very much for your interest,
Andrés Sánchez Pernaute, PhD, MD
Hospital Clínico San Carlos
Hospital Universitario Quirón
Madrid
Spain
