Dr Jason Free

The facts about SADI

SLEVE GASTRECTOMY PLUS DUODENO - ILEOSTOMY PROCEDURE, KNOWN AS SADI PROCEDURE HAS THE GREATEST WEIGHT-LOSS OF ALL THE COMMONLY PERFORMED WEIGHT-LOSS PROCEDURES. IT HAS THE LONGEST LASTING EFFECTS, WITH LESS LATE WEIGHT REGAIN WHICH IS BECOMING NOTICEABLE IN PATIENTS WHO HAVE HAD SLEEVE GASTRECTOMY IN THE PAST.

The SADI procedure is an operation incorporating a sleeve gastrectomy with bypassing part of the intestine. It has the greatest effect on improving medical disorders associated with obesity such as diabetes, hypertension and high lipids and cholesterol. As such it is generally reserved for patients with a very high BMI (BMI>45) and those with significant medical complications due to obesity. As with all weight-loss procedures it is a laparoscopic (keyhole) procedure performed under a general anaesthetic. The operation involves two parts: Firstly part of the stomach is removed making a smaller stomach similar to a sleeve gastrectomy. Then the first part of the intestine (duodenum) is divided just below the stomach and anastomosed (reattached) to a loop of intestine about 2 metres further downstream. This has the effect of decreasing appetite, restricting meal sizes, and bypassing food away from the metabolically active part of the intestine resulting in beneficial hormonal changes which have a positive influence on the body’s metabolism. The important thing to know about this procedure is that the bowel is divided below the pylorus. The pyloric valve and its function are preserved, unlike in the gastric bypass or mini-gastric bypass. The pyloric valve has an important role in regulating the rate at which food & acid enters the intestine from the stomach. It also prevents bile from refluxing from the duodenum back up into the stomach which can cause stomach irritation. The preservation of the pylorus in the SADI procedure maintains it’s important function. The problem of bile entering the stomach which can occur with the mini-gastric bypass is therefore prevented in the duodenal bypass. The preservation of the pyloric valve in the SADI procedure also eliminates the dumping syndrome which can occur with standard gastric bypass procedures. The glucose fluctuations after a meal do not occur after this procedure. There is also a dramatic reduction in the formation of ulcers forming at the anastomosis site which can happen in standard gastric bypass.

Dr Jason Free BVSc (HONS) MBBS (Qld) FRACS Specialist Bariatric Surgeon

SADI procedure

The procedure is becoming increasingly useful for patients who have had a prior sleeve gastrectomy and either have not had as much weight-loss as expected, or have lost-weight and regained weight later on. In the past these patients have often had their sleeve gastrectomy converted to a standard gastric bypass, however evidence shows that this also may not provide robust long term weight loss. The SADI procedure is showing extremely promising results after previously failed sleeve gastrectomy. The SADI procedure has been developed to such an extent that it provides the most weight-loss, the longest lasting weight-loss, and the most beneficial effect on medical problems associated with obesity, compared to all other procedures. It has been refined to the point at which the long-term problematic issues have been minimalised making it an extremely safe and effective operation.

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SADI Procedure

The SADI procedure (Sleeve Gastrectomy plus Duodeno- Ileostomy) involves a sleeve gastrectomy with bypass of part of the small intestine. The weight-loss and resolution of medical disorders is much more than a sleeve gastrectomy alone. This procedure is preferred over Gastric Bypass as it avoids many of the long-term problems some patients with gastric bypass experience. Dr Free has pioneered this procedure in Australia and modified it to improve it’s long term safety whilst maintaining improved weight-loss. Dr Free continues to lead research comparing the various types of SADI and other weight-loss procedures.

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SAFE PROCEDURES. EFFECTIVE RESULTS SAFE PROCEDURES. EFFECTIVE RESULTS

Dr Jason Free is one of Australia’s most highly-regarded experts in weight-loss surgery, with extensive specialist bariatric training, and is k kn no ow wn an as a fs a fo or re em mo os st st su ur rg ge eo on in in tn th he fie fie el ld d. .