Robotic SADI – Single Anastomosis Duodenoileal Bypass

At Blackrock WeightCare we perform a SADI-S (Single Anastomosis Duodeno-Ileal bypass- with Sleeve) procedure. It provides at least the same weight loss compared to all other weight loss surgical procedures.

SADI-S also seems to have the longest-lasting effect, with less late weight regain. Weight regain is becoming noticeable in patients who have had sleeve gastrectomy in the past.

Ideal patient:

  • BMI over 50
  • Diabetes/high cholesterol/metabolic complications of obesity
  • Failure of previous sleeve gastrectomy
  • Weight regain after sleeve gastrectomy

Robotic SADI Overview

The SADI procedure is an operation incorporating a sleeve gastrectomy PLUS bypassing part of the intestine.

It probably provides the most dramatic weight loss relative of all the currently performed procedures with no apparent increase in side effects. SADI-S also has the greatest effect on improving medical disorders associated with obesity such as diabetes. As such it is generally reserved for patients with a very high BMI (BMI>45) or those with significant medical complications due to obesity.

At Blackrock WeightCare, William Robb performs the SADI-S by robotic surgery. This makes the trickier parts of the surgery much more straight forward and in our hands we believe robotic surgery adds to patient safety.

Quick guide

How is the Robotic SADI procedure performed?

Firstly, a sleeve gastrectomy-type procedure is performed and the excess stomach is removed.

Secondly, the first part of the intestine (duodenum) is divided just beyond the exit valve (pylorus) of the stomach and this is joined to a loop of intestine about 2.5-3 metres from the end of the small intestine. The operation decreases appetite, restricts meal size and bypasses the length of the small intestine resulting in beneficial hormonal changes which have a positive influence on the body’s metabolism.

Mechanically this operation has several advantages over a traditional roux-en-y gastric bypass (RYGB). The pyloric valve (exit valve of the stomach) is preserved – unlike in the gastric bypass or one anastomosis (mini) gastric bypass. This exit valve of the stomach (pylorus) has an important role in regulating the rate at which food & acid enters the intestine from the stomach. It also prevents bile from refluxing back into the stomach from the duodenum which can cause significant reflux symptoms.

The preservation of the stomach’s exit valve in this operation usually eliminates dumping syndrome which can occur with standard gastric bypass procedures. Glucose fluctuations after a meal do not occur to the same extent and the risk of episodes of hypoglycaemia is reduced. There is also a reduction in the formation of ulcers at the anastomosis site.

Similar to a RY-Gastric Bypass, a SADI-S bypasses part of the small intestine so there is some potential for patients to develop deficiencies in vitamins, minerals, protein & trace elements similar to gastric bypass. Therefore it is important for patients to maintain ongoing surveillance and annual blood tests.

Your Health – We Care. Blackrock WeightCare follows up with all patients for a minimum of 2 years to ensure that any risk is minimised and we help teach you how to self-care in the years ahead. Read more about our Weight Loss Aftercare here.

SADI following sleeve gastrectomy – revisional surgery

The procedure is becoming increasingly useful for patients who have had a prior sleeve gastrectomy and;

  1. Have not had as much weight loss as expected, or,
  2. Have 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 as much further weight loss as desired or robust long-term weight loss.

The SADI procedure is showing extremely promising results after a previously failed sleeve gastrectomy.

In Summary

The SADI procedure has been developed to provide excellent weight loss, the longest-lasting weight loss, and the most beneficial effect on medical problems associated with obesity, compared to all other procedures.

Robotic SADI – Single Anastomosis Duodenoileal Bypass Enquiries

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    Go Surgical Limited
    Suite 9, Blackrock Clinic, Blackrock Road, Dublin A94 E4X7