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The Single Anastomosis Duodenal-Ileal Bypass with Sleeve Gastrectomy, referred to as the SADI-S or Loop Duodenal Switch, is the newest procedure to be endorsed by the American Society for Metabolic and Bariatric Surgery (ASMBS).

The procedure

The surgery starts the same way as the sleeve gastrectomy, making a smaller tube-shaped stomach. The first part of the small intestine is divided just after the stomach. A loop of the intestine is measured several feet from its end and is then connected to the stomach. This is the only intestinal connection performed in this procedure.

Gastric Bypass Surgery

When the patient eats, food goes through the pouch and directly into the latter portion of the small intestine. The food then mixes with digestive juices from the first part of the small intestine. This allows enough absorption of vitamins and minerals to maintain healthy levels of nutrition. This surgery offers weight loss along with less hunger, more fullness, blood sugar control and diabetes improvement.

(click photo to enlarge)


  • Highly effective for long-term weight loss and reduced risk of obesity-related health conditions
  • Simpler and faster to perform (one intestinal connection) than gastric bypass or BPD-DS
  • May result in improved metabolic health
  • Excellent option for a patient who already had a sleeve gastrectomy and is seeking further weight loss


  • Vitamins and minerals are not absorbed as well as in the sleeve gastrectomy or gastric band
  • Newer operation with only short-term outcome data
  • Potential to worsen or develop new-onset reflux
  • Risk of looser and more frequent bowel movements

Watch the video below to learn more about SADI-S.