SADI-S / Loop - Please share facts about this new procedure here.

[more2adore]

Yep, they're visible now.

 

[brooklyngirl]

Ditto!

 

[star0210]

Have you seen a study like that that looks at revising to DS after a failed VSG or a study on the DS when done in 2 stages?
I've searched a little, but I'm not good at finding these things.

 

[revisionDS]

(1) The theoretical advantage to the individual SADI patient, *if long term results are equivalent to the DS and there are no new complication exposures*, would be access to a pyloric-preserving, band-free bariatric surgery with a reduced operating time /less anesthesia and one less anastomosis with the potential to leak, and less surgeon fatigue, so perhaps some increased safety. Over time, there may also be some theoretically-reduced risk of nutritional challenges.

(2) The theoretical advantage to the MO, SMO, SSMO population at large would be increased access to a pyloric-preserving, band-free bariatric surgery. The vetted DS surgeon list is currently short because it is a difficult procedure which requires significant skill and experience. If the SADI is easier for the surgeon, perhaps more surgeons will be willing and able to perform it well. This, to me, is the biggest benefit. Accessibility.

(3) The risks to the SADI patient are: (a) limited information - both about long term success/failure rates and complications (theoretical bile reflux possibility), (b) a theoretical potential need for future reoperation to convert SADI into traditional DS at a later point if weight loss is not successful over the long term, (c) limited experience with the procedure by most surgeons given it is so new, and (d) some of the doctors appear to be not providing appropriate disclosures for SADI, which calls into question, in my mind, the ethics of those specific surgeons.

Great summary, I had sent out a post a while back about what would happen to the DS in the furture as a surgery as it is a difficult surgery for the surgeon as it has a high learning curve etc and patient must be diligent etc. it is not a surgery to take lightly. I think it is important to know what you are willing to do and accept as a surgeon and as a patient. At this point the DS is a superior sugery due to well established resolution of comorbs, % of weight loss and surgery with the least weight recidivism. I agree more drs would do the SADI if trained, easier etc.while it is a new surgical procedure for about 3 years I still think it is better than gastric band, RNY and stand alone VSG. I do think one of the best features of DS is it's customability in the hands of an experienced DS surgeon, s/he can make those 2 limbs custom to absorb more or less fat as in the common channel adjustment.
With the choices out there now for WLS, SADI may be an option for osteopenia patients, since fat is not selectivley malabsorbed as with DS, which is a major benefit of the DS and beleived to be the long term reason that weight recidivism is kept to a minimum even many years out. VitD malabsorption would not play such a large deciding factor for these patients, but calcium malabsorption still would.
It is time for a new surgery, I don't believe SADI will replace DS, but is it "good enough", will it bring enough resolution of comorbs, and a good quality of life, that is the question. I think it will be a better option than the gastric band, RNY and stand alone VSG.

 

[jillc]

Have you seen a study like that that looks at revising to DS after a failed VSG or a study on the DS when done in 2 stages?
I've searched a little, but I'm not good at finding these things.

I think this page has an abstract of a study http://www.dsfacts.com/duodenal-switch-as-a-revision-surgery.php

 

[MeganR]

Hi all new here but read this whole thread. I am considering this and the surgeon I have has done over 50. I just can't see the negative consequences of this surgery.

 

[star0210]

Hi all new here but read this whole thread. I am considering this and the surgeon I have has done over 50. I just can't see the negative consequences of this surgery.

The only negative is that we just don't know how well the stats are going to hold up 10-15-20 yrs down the line.

 

[DianaCox]

Hi all new here but read this whole thread. I am considering this and the surgeon I have has done over 50. I just can't see the negative consequences of this surgery.

1) Long term results are unknown
2) No selective fat malabsorption - so no free ride on eating fat - i.e., dieting
3) If it fails you, you are going to need a reoperation, which may NOT be covered by insurance
4) If it fails you, you are likely to not get as good results from a revision that you would have had as a virgin DS surgery (revisions are less likely to be as effective)
5) You are going to have the same mineral absorption issues

 

[revisionDS]

@hilary1617 Great new pic!!!

 

[hilary1617]

Thanks @revisionDS ! Mixing it up a bit.

 

[Larra]

What Diana said. It looks to be better than gastric bypass but probably not as effective or as easy to live with (diet wise) as DS. If surgeons start doing this INSTEAD of gastric bypass a lot of people who would otherwise be stuck with gastric bypass will benefit. If they do it instead of DS a lot of potential Ds patients will not benefit as much as they could. The lack of known longterm results is a problem for me. Granted, there was a time when the longterm results of DS were not known, but we do know them now, and they're excellent, not just for weight loss but also for resolution of comorbidities. We just don't know this for SADI.

 

[Elizabeth N.]

My possibly pie-in-the-sky dream is that the SADI type procedures will render RNY obsolete and that DS will remain as an option.

 

[BKLYN07]

My possibly pie-in-the-sky dream is that the SADI type procedures will render RNY obsolete and that DS will remain as an option.

Hi good morning!! I know that Dr Roslin informed that he feels the SADI will replace the RNY. I do know that Dr Roslin doesn't do the RNY because of the high percentage of weight gain. I feel that the DS will always be an option because the weight loss results are excellent!! Dr Roslin gave me the option along with his opinion and I choose the SADI which is currently working well for me!!! Enjoy your day!!!

 

[Elizabeth N.]

Cool! When was your surgery and how are things going?

 

[BKLYN07]

Cool! When was your surgery and how are things going?

I had the surgery on 12/3/13 and HW 268 and I range between 111-114. Nutritionist told me to do low fat! I realized this doesn't work for me because it causes constipation. High fiber causes constipation, too. I gave all the low fat products away and bought regular mayo and dressing. I really don't like fried foods but I do enjoy skirt steak, salmon ,broiled filet of sole , lobster and beef stew!!!