Single Anastomosis Duodenal Bypass Perth
Carlo lost 35kg after his SADI procedure.
Expected excess weight loss:90% Excess Weight Loss
Average procedure time:2 hours
Average recovery time:3 weeks
SADI or Single Anastomosis Duodenal Bypass
What is a Duodenal Switch?
Duodenal switch surgery is the most aggressive operation available for weight loss, and has many advocates among weight loss surgeons worldwide. However, the complications of this bariatric surgery include significant diarrhoea, and patients do experience serious issues with long term malnutrition.
A duodenal switch is also known by the name Laparoscopic Biliopancreatic Diversion, or lap biliopancreatic diversion, (BPD). In Australia, the true BPD is not popular amongst bariatric surgeons or patients. At our Perth clinic, we do offer this surgery in certain circumstances, but it demands lifelong intensive follow up and vitamin tracking.
What has now taken over from the BPD is the SADI/SIPS procedure, the single anastomosis duodenal bypass. This is a modified version of the BPD procedure that provides similar “aggressive” weight loss. The benefit is that there is less of the diarrhoea, making the procedure better tolerated by patients. However, it still does create significant diarrhoea.
How does it work?
The SADI procedure causes true malabsorption as calories are not absorbed easily once it has been performed. Food moves very quickly through the bypass area and through to the column. This means there is only a very limited time for your gut to absorb the calories. It will cause your bowels to loosen in the first year (or more), but then things do settle over time. Carbohydrates need to be avoided as they are strongly associated with triggering the diarrhoea.
The SADI also results in an increase in the production of Incretin hormone. This group of metabolic hormones stimulates a decrease in blood glucose levels, by augmenting the secretion of insulin released from the pancreas. Calories that are delivered to the end of the small bowel in undigested form stimulate the FXR receptor and cause the release of Incretin. This hormone, in turn, acts on the hypothalamus to turn off your appetite, helping you to avoid food.
How long will I be in hospital?
After weight loss surgery, most patients are in hospital for 4-5 days. If you are recovering well you may get home a little sooner.
On the third day, we will do a CT scan to make sure there is no leak from the internal surgical sites. This is also good for early detection of any issues that may impact your recovery.
When all is working well, we will let you go home.
How soon before I can return to work?
We recommend two weeks off from work. Most people return to work three weeks post-surgery. If you have a very physical job, then taking an extra third or fourth week off from work may be advised by your specialist. If your job is office-based, or if you work from home, then you may get back to work a little sooner.
It’s always best to keep in mind, however, that even though you’re feeling well, you are still recovering from surgery and will not be performing at your best.
When can I drive?
About Obesity Surgery WA: Our 6 commitments
Taking surgery seriouslyWe know that entering into an operation is a big deal and we are very serious in getting the best outcome for you. We practice what is considered to be a world class standard. Our staff regularly attend national and international conferences and bring back what is the latest research and technology.
Running on timeOur Surgeons and all of our staff try their best to run on time. Although it's not always possible, our commitment is that we do our best. Your time is valuable and we respect that.
Readily availableOur surgeons (or at least one of them) are always available in a crisis. Some of them may provide you with a direct contact, but all are available through the hospital switchboard and happy to chat any time if there is a crisis.
An obsessive attention to detailWe do our best to not miss anything. Every stitch, every staple and every clip is applied to exactly where it needs to be with the greatest care possible.
Commitment to performing the best operation possibleNot all operations are the same and there a few extras that we do to make things better. We know that our results are better with the minimiser ring so we offer it to everyone. We know that reflux can be an issue so we try to tighten every oesophageal hiatus to make reflux control as good as possibly can be.
A commitment to new technologies
- We have brought in STRETTA into Western Australia, which we believe will revolutionise reflux management. (Have a look at the Stretta page for more information).
- SJOG Murdoch has just purchased a new DaVinci robot and we believe that this will allow us to do operations with keyhole surgery that previously needed a major laparotomy incision. Lynx is on the horizon and promises to also help manage reflux, we hope to have access to this in early 2020.
Obesity Surgery WA is lead by Dr Harsha Chandraratna. After graduating at UWA, Harsha began his surgical training and was made a Fellow of the Royal Australasian College of Surgeons in 2001. Dr Chandraratna understands the impact of obesity. He personally had sleeve gastrectomy surgery, which gives him a really deep level of understanding when he works with his patients on a daily basis.
Meet our team
Dr. Harsha Chandraratna
Dr Andrew Kiyingi
Bariatric & General Surgeon
MBChB, PGDipSurgAnat, FRACS
Dr. Bill Gong
General and Laparoscopic Surgeon