The SADI procedure is a combination restrictive, hormonal and malabsorptive procedure. It involves both a sleeve gastrectomy along with intestinal bypass although unlike gastric bypass procedures the bypass is between the duodenum and ileal parts of the small bowel. Obviously patients have restriction from the sleeve component of the procedure but also have an element of malabsorption and hormonal changes which can enhance weight loss and is more effective at stopping weight regain in the long term. The advantage of having the bypass between the duodenum and the small intestine is that SADI patients have an intact pylorus so are less likely to experience dumping but more importantly they do not suffer from ulcers typically seen in gastric bypass procedures. This means that SADI patients are able to have medications like anti-inflammatories which are generally contraindicated in gastric bypass patients. Like sleeve gastrectomy laparoscopic gastric bypass also alters some of the hormones involved in appetite control and hence helps to control appetite as people lose weight.
Probably the biggest group to benefit from the SADI procedure are diabetic patients. Bypassing the first part of the small intestine changes gut hormones directly involved in glucose control. Around 80% of non-insulin diabetic patients will leave hospital following their surgery without any diabetic medication. For many type 2 diabetics who are insulin dependent they are able to stop their insulin which dramatically improves their ability to lose weight.