SADI-S in Medellín: single-anastomosis duodenal switch
About COP 32,000,000, done laparoscopically with about one day in the hospital
SADI-S, also called SADS or single-anastomosis duodenal switch, combines a gastric sleeve with a change in the path food takes through the intestine. It is one of the bariatric surgeries with the greatest weight loss, and it requires vitamins and follow-up care for life. At MDE Care we tell you the cost before you decide, connect you with a certified bariatric surgeon and coordinate your assessment, your tests and, if you are traveling, your stay in Medellín.
~2 h
of surgery
~1 day
in the hospital
72.88%
of excess weight at 5 years
60 to 80%
diabetes remission
USD 18,000 to 35,000
cost in the United States
Is SADI-S an option for your case?
SADI-S is not the first surgery for everyone. Answer four questions and we will show you when it is usually considered, how much it costs and what results have been published.
1. Your height and weight
Your BMI
47.8
Severe obesity
2. Have you already had a gastric sleeve?
3. Do you have type 2 diabetes?
4. Can you commit to vitamins and follow-up care for life?
SADI-S reduces nutrient absorption: daily supplements and regular lab tests are mandatory. See the plan.
Your guidance
Answer the questions to see your guidance
Please indicate whether you have had a gastric sleeve, whether you have type 2 diabetes and whether you can commit to supplementation.
General guidance based on published guidelines and studies. It does not replace the judgment of the bariatric surgeon, who decides on the technique at the assessment.
SADI-S cost
Surgery, estimated cost
AboutCOP 32,000,000
What is included is detailed in the quote, after the assessment.
Average results at 5 years
33.67%
of total weight
72.88%
of excess weight
At your weight, 33.67% is about 44 kg less on average at 5 years.
60 to 80% type 2 diabetes remission
Not included
COP 150,000 to COP 300,000
Assessment consultation with the bariatric surgeon.
In the United States, SADI-S costs between USD 18,000 and 35,000.
* Estimated costs. The final quote is provided after the assessment, based on your case and your tests. Results are published averages, not a guaranteed result.
Your supplement plan after SADI-S
Because food bypasses much of the small intestine, the body absorbs less fat, vitamins and minerals. These are the daily minimums the ASMBS recommends for the duodenal switch. Check off each one as you understand it.
You have reviewed 0 of 6
0%
Every day
Multivitamin
For life
Purpose: covers the micronutrients that are absorbed less. After a duodenal switch, it is prescribed with high doses of fat-soluble vitamins and calcium.
Per day
Vitamin A
10,000 IU
Purpose: a fat-soluble vitamin, absorbed along with fat, that supports vision and skin health. It is measured in the lab tests of the first year.
Per day
Vitamin K
300 µg
Purpose: also fat-soluble, it plays a role in blood clotting.
Per day
Calcium
1,800 to 2,400 mg
Purpose: protects bone health, which depends on the intestine absorbing enough calcium.
Per day, at least
Thiamine (vitamin B1)
12 mg
Purpose: supports the nervous system. It is a minimum for all bariatric patients.
Per day
Elemental iron
45 to 60 mg
Purpose: prevents anemia. The ASMBS recommends it after a duodenal switch, bypass and gastric sleeve.
Your daily life with SADI-S
~2.5
bowel movements a day on average, which may be softer than before surgery.
Regular lab tests and follow-up visits for life, to adjust doses in time.
With adequate supplementation, nutritional deficiencies are uncommon.
For reference, in the United States a year of lab tests and supplements costs between USD 1,500 and 2,500. The exact regimen is set by the team based on your lab results.
What SADI-S is and how it works
SADI-S stands for single-anastomosis duodeno-ileal bypass with sleeve gastrectomy. First, a gastric sleeve is created, calibrated with a 54 French bougie. Then the duodenum is divided just past the pylorus and joined, with a single anastomosis, to a loop of ileum about 250 to 300 cm from the ileocecal valve, the end of the small intestine.
This way it works in two ways: the smaller stomach reduces how much you eat, and food bypasses much of the small intestine, which reduces calorie absorption. It is a modification of the classic duodenal switch, endorsed by the ASMBS, also known as SADS or loop duodenal switch.
- 1
54 French gastric sleeve
The stomach is shaped into a tube and the pylorus, the stomach outlet valve, is preserved.
- 2
Division of the duodenum
The duodenum, the first part of the intestine, is divided past the pylorus.
- 3
A single connection to the ileum
The duodenum is joined to the ileum about 250 to 300 cm from the end of the small intestine. Food bypasses the rest of the path.
How SADI-S is performed
SADI-S is performed laparoscopically, through small incisions and a camera. The surgery takes about two hours and the hospital stay is about one day.
Laparoscopic
Minimally invasive.
About 2 hours
The classic duodenal switch takes 3 to 5.
About 1 day
In the hospital.
Compared with Roux-en-Y gastric bypass, the time in the operating room is similar. Compared with the classic duodenal switch, which requires two intestinal connections, SADI-S is faster and simpler, with similar results according to the ASMBS.
SADI-S, classic duodenal switch or gastric bypass
All three are surgeries with a malabsorptive component. This is what published studies show.
| SADI-S | Classic duodenal switch | Roux-en-Y gastric bypass | |
|---|---|---|---|
| Duration | About 2 hours | 3 to 5 hours | Similar to SADI-S |
| Weight loss | 33.67% of total weight at 5 years | Similar to SADI-S, according to the ASMBS | 10.03 points less total weight loss than SADI-S |
| Type 2 diabetes | 60 to 80% remission | The surgeon explains it at the assessment | 60 to 80% remission; in comparative studies, SADI-S achieved more remission |
| Nutritional demands | High, for life | High, for life | Lower than with SADI-S |
| Cost in Medellín | About COP 32,000,000 | Quoted after the assessment | From COP 26,000,000 |
| Cost in the U.S. | USD 18,000 to 35,000 | USD 20,000 to 40,000 | USD 20,000 to 35,000 |
Compared with bypass
In 8 studies with 4,259 patients, SADI-S achieved more weight loss and more diabetes remission. With a BMI under 50, it also had fewer serious complications. On the other hand, it carries a higher risk of nutritional deficiencies and soft stools.
Compared with the sleeve
SADI-S starts from a gastric sleeve and adds a malabsorptive component, which is why it achieves more weight loss. On the other hand, it requires lifelong supplementation and follow-up. Learn about the gastric sleeve.
Who is a candidate for SADI-S?
It is usually considered when
- There is severe obesity, with a BMI of 40 or higher, and other methods have not worked.
- There is super obesity, with a BMI of 50 or higher, or a high surgical risk.
- You have already had a gastric sleeve and lost little weight or regained it: SADI-S is a revision option.
- There is a commitment to vitamins and follow-up care for life.
General ASMBS and IFSO (2022) criteria for any bariatric surgery: a BMI of 35 or higher, or 30 to 34.9 with metabolic disease.
What is assessed carefully
- Being unable to take supplements and have lab tests for life.
- Reflux, because SADI-S includes a gastric sleeve.
- A BMI under 35: SADI-S is considered for severe obesity, so the surgeon assesses other techniques.
The contraindications for your case are determined by the bariatric surgeon at the assessment. Still not sure which technique is right for you? Use the bariatric surgery guide.
How much weight is lost with SADI-S
A systematic review of 1,088 patients, with an average starting BMI of 49.66, followed the results for 5 years.
33.67%
of total weight
lost at 5 years
72.88%
of excess weight
lost at 5 years
49.66 to 31.7
Average BMI
at the start and at 5 years
Related conditions that improve
Type 2 diabetes
60 to 80%
remission
High cholesterol
Over 70%
dyslipidemia remission
Sleep apnea
Over 80%
remission
Published averages. Each patient's result depends on their case, adherence and follow-up. This is not a guaranteed result.
Recovery and diet after SADI-S
Your diet, week by week
First day
Hospital stay of about one day
First weeks
Full liquid diet
Following weeks
Soft diet
Up to the third month
Gradual return to regular food, in small portions
The exact length of each phase is set by the nutrition team based on your progress.
Normal activities within a month
The return to normal activities is gradual and is usually complete within a month. When to return to work is decided by the surgeon based on your recovery and your type of work.
Follow-up care for life
Regular lab tests make it possible to adjust your vitamins and detect any deficiency early. See the supplement plan.
Risks of SADI-S
Like any surgery, SADI-S has risks. The surgeon reviews them with you at the assessment, and lifelong follow-up care exists to detect them early.
Short-term complications
5.4 to 11.6%
of patients, according to a meta-analysis.
Long-term complications
8.7 to 17.9%
of patients, according to the same meta-analysis.
Protein malnutrition
This is the risk specific to the technique. Reoperations for malnutrition were associated with a 200 cm common channel; the technique described by the IFSO joins the ileum 250 to 300 cm from the end of the intestine.
Changes in digestion
Bowel movements average about 2.5 a day, and soft stools are more common than with bypass.
As a sleeve revision
Conversion to SADI-S had more anastomotic leaks than conversion to bypass, but fewer major complications in the first 30 days.
The ASMBS endorses SADI-S but calls for more long-term safety data. The bariatric surgeon will explain what this means for your case.
Your SADI-S in Medellín, step by step
The hospital stay is about one day; how many days you should stay in Medellín is decided by the surgeon based on your case. Because SADI-S requires follow-up care for life, we agree from the start on how your follow-up will work once you return home.
Step 1
Contact us on WhatsApp
Tell us about your case, your height, your weight and any previous surgeries.
Step 2
Video call with the surgeon
Initial assessment without traveling.
Step 3
Pre-surgery tests
Those the surgeon orders for your case.
Step 4
Quote in US dollars
With a breakdown of what is included.
Step 5
Surgery and recovery
With the option of a recovery house with nursing care: USD 270 per night in a standard room.
Step 6
Remote follow-up
Telehealth visits and lab tests in your country to adjust your supplements.
About SADI-S in Medellín
How much does SADI-S cost in Medellín?
What is SADI-S and how is it different from the duodenal switch?
How much weight is lost with SADI-S?
Is SADI-S better than gastric bypass?
Can SADI-S be done after a gastric sleeve?
How does digestion change after SADI-S?
How long are the hospital stay and recovery?
What vitamins do I need to take after SADI-S?
Not sure whether SADI-S is the right technique for you?
The bariatric surgery guide compares your case with every option, with and without surgery.
Other bariatric surgery options
Request your SADI-S quote in Medellín
Tell us your height, your weight, whether you have had previous bariatric surgery and where you are traveling from. We will send you the cost of your process and coordinate your assessment with the bariatric surgeon.