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SADI-S Surgery
SINGLE ANASTOMOSIS DUODENO-ILEAL BYPASS with SLEEVE GASTRECTMOY
WHAT IS SADI-S?
In 2003, Dr. It was presented to the literature by Sanchez. First, sleeve gastrectomy is performed on the patient and the gastric outlet is closed, and a new path is created between the formed tube stomach and the last 300 cm of the small intestine. It can also be described as gastric bypass with sleeve gastrectomy.
WHY DID THE DIETS I MAKE TO GET OUT OF OBESITY NOT WORKING?
Adult gastric volume is 600-900cc and takes 2-3 portions of food. When the stomach is full, a “feeling of fullness” occurs. It is essential to “restrict food/calorie intake” in all diets, but when the stomach is not full, dieters do not feel “full” and quit the diet.
For the feeling of satiety, it is either "full filling" of the stomach or reduction of the stomach volume (sleeve gastrectomy).
Morbidly obese (BMI>40) individuals are less likely to decrease to the “ideal BMI” value with only diet and exercise <2%
The average success rate of SADI-S surgery in bariatric surgery is 95%, and its success in achieving remission in Type 2 Diabetes is between 95-98%.
IS OBESITY SURGERY SAFE DURING THE CORONA VIRUS PANDEMIC?
Patients with metabolic disorders like cardiovascular diseases, diabetes and obesity may face a greater risk of infection of COVID-19 and it can also greatly affect the development and prognosis of pneumonia
Source: (https://pubmed.ncbi.nlm.nih.gov/32386567/)Studies have also shown that prior bariatric surgery conveys protection against mortality from COVID-19 and that obesity is the biggest risk factor for mortality from COVID-19 infection in adults. Bariatric surgery has been safely performed in patients who made a full recovery from COVID-19 without increased complications due to cardiovascular, pulmonary, venous thromboembolism, or increased mortality rates.
Source: (https://pubmed.ncbi.nlm.nih.gov/34446386/)The following positive results were also reported in the Italian study; Introduction of strict COVID-19 protocols concerning the protection of patients and health-care professionals guaranteed a safe response of elective BMS in Italy. The safety profile was, also, maintained during the second wave of outbreak, thus allowing access to a cure for the obese population.
Source: (https://pubmed.ncbi.nlm.nih.gov/34133962/ )IS OBESITY SURGERY SAFE DURING THE CORONA VIRUS PANDEMIC?
Patients with metabolic disorders like cardiovascular diseases, diabetes and obesity may face a greater risk of infection of COVID-19 and it can also greatly affect the development and prognosis of pneumonia
Source: (https://pubmed.ncbi.nlm.nih.gov/32386567/)Studies have also shown that prior bariatric surgery conveys protection against mortality from COVID-19 and that obesity is the biggest risk factor for mortality from COVID-19 infection in adults. Bariatric surgery has been safely performed in patients who made a full recovery from COVID-19 without increased complications due to cardiovascular, pulmonary, venous thromboembolism, or increased mortality rates.
Source: (https://pubmed.ncbi.nlm.nih.gov/34446386/)The following positive results were also reported in the Italian study; Introduction of strict COVID-19 protocols concerning the protection of patients and health-care professionals guaranteed a safe response of elective BMS in Italy. The safety profile was, also, maintained during the second wave of outbreak, thus allowing access to a cure for the obese population.
Source: (https://pubmed.ncbi.nlm.nih.gov/34133962/ )WHICH PATIENTS IS THE SADI-S PROCEDURE APPLIED?
BMI>50 morbidly obese patients
Patients with BMI>40 and Type 2 Diabetes
Patients with BMI>40 and Hypertension and increased risk of cardiovascular disease
Patients with BMI>40 and Dyslipidemia
Patients with BMI>40 and Sleep Apnea
Patients with BMI>40 and Metabolic Syndrome
In patients who "gain weight back" after Sleeve Gastrectomy surgery
In patients with “Type 2 Diabetes Relapse” after sleeve gastrectomy
Metabolic diseases requiring revisional surgery after sleeve gastrectomy
WHICH SURGEON SHOULD I CHOOSE FOR MY SADI-S SURGERY?
Obesity The most important criterion in Bariatric and Metabolic surgery is the choice of surgeon. Surgeons who have performed a total of 400 or more bariatric surgical procedures according to IFSO criteria are considered "expert surgeons". Your surgery will be performed by Expert Bariatric Surgery Specialist, Ersun Topal, MD, General Surgeon. He has 9 years of bariatric surgery experience and >1500 cases (sleeve gastrectomy, rny gastric bypass, omega/mini gastric bypass, sadi-s, duodenal switch-biliopancreatic). diversion, revisionally surgery) has extensive experience and is a member of IFSO and Turkish Obesity Surgery Society
Source: (http://www.turkishobesitysurgery.com/information) (https://www.ifso.com/)
HOW IS SADI-S TECHNIQUE DONE?
Your surgery will be performed with laparoscopic tecnic through 4-5 holes in the abdominal wall. In the first step of the operation, the stomach is reduced in the form of Sleeve Gastrectomy.
In the second step, the exit of the stomach is cut and closed.
in the last step; the last 300 cm of the small intestine is joined to the exit port of the stomach (anastomized).
final state of the surgery
IS THE SADI-S PROCEDURE A RELIABLE PROCEDURE?
Among the bariatric surgical techniques, it is a low-risk bariatric surgery procedure.
The surgeon's experience and the quality of titanium staples used are very important. Only U.S FDA (Food and Drug Administration; The FDA is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products) approved Medtronic Endoscopic Staples is used in our clinic.
Absolutely replica/cheap Chinese brands staples are not used!!
WHY SHOULD I PREFER ISTANBUL BARIATRIC CLINIC?
A-Surgeon's experience (+1500 bariatric and metabolic surgeries)
B-Using FDA approved Medtronic Tri-Staples Tech stapler
WHAT ARE THE RISKS OF SADI-S procedure?
In the first 30 days, the rate of re-admission to the hospital was 1.8%,
anastomotic line leaks (0.2-0.6%)
mortality rate 0.2%
nausea (2.2%)
superficial surgical site infection (2.2%)
stenosis in the anastomosis line (0.1-2.9%),
diarrhea/steatorrhea 14%
WHAT SHOULD I DO BEFORE SADI-S SURGERY?
You should start “healthy eating” from the moment you decide to have the surgery, you should quit alcohol for your liver health, For your lung health, you should quit smoking. You must stop all painkillers (ibuprofene, diclophenac, Naproxen and etc non-steroidal anti-inflammatory drugs) except Paracetamole. You should start to drink 1 of the over-the-counter Proton (Pantaprasole, Esomeprazole, Lansaprasole ext.) every morning on an empty stomach.
IS CHECK-UP REQUIRED BEFORE SADI-S PROCEDURE?
Before obesity surgery, blood tests, chest X-ray, Electro-cardiography, upper gi endoscopy (with and under sedation anesthesia) will be performed. If you have heart disease or diabetes, you will be consulted.
DO I HAVE TO PAY EXTRA FEE FOR THE CHECK-UP TRANSACTIONS TO BE MADE BEFORE SADI-S?
You will not pay extra-charges for the “standard tests and examinations” that must be done before the surgery.
WILL I HAVE PAIN AFTER SADI-S SURGERY?
Before your surgery begins, pre-medication will be administered to control analgesia. Also “A patient controlled analgesia (PCA) system allows you to give yourself a dose of intravenous pain medicine, with the push of a button. This system decreases any pain and anxiety you may feel while waiting for medicine.
Source: (https://www.mayoclinic.org/patient-controlled-analgesia-pca/img-20008231#:~:text=A%20patient%20controlled%20analgesia%20(PCA,feel%20while%20waiting%20for%20medicine)Frequently Asked Questions
In bariatric and metabolic surgery, the quality of the stapler to be used determines the quality of the surgery. Only Medtronic Tri-Staple Tech original American product is used in our clinic. We definitely do not use the cheaper Chinese made staplers.
After your surgery, you will start feeding with foods prepared by your Bariatric Surgery Dietitian in accordance with the “AACE/TOS/ASMBS Guidelines Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient”.
Our Bariatric Surgery Dietitian, who is part of our clinical team, will follow you online free of charge for the first year
Early mobilization of patients is recommended 4 hours after bariatric surgery.
Our clinical nurses will take care of you closely. A company will not be required.
After bariatric surgery, you will be discharged from the hospital after 72-96 hours under routine conditions.
You can shower after 4 DAYS following laparoscopic bariatric surgery.
After being discharged from the hospital, Istanbul or Bursa, Iznik (Iznik is the place where the first ecumenical (universal) council of Christianity was held. In other words, in 325 AD, 228 bishops from all over the world attended and the basic principles of the Christian religion were discussed and decided. The only church accepted by the Christian sect, St. Koimesis Church, St. Neophytos Basilica) Ephesus, Meryem Ana church can be visited.
After being discharged from the hospital after bariatric surgery, there is no obstacle for you to travel by car or plane.
You can return to work within 7-14 days after Gastric Bypass.
After bariatric and metabolic surgery, there is no obstacle to activities such as walking, jogging, cardio, yoga in the first week, swimming running spinning from the 2nd week, pilates, step, aerobic, zumba, weight lifting from the 3rd week.
Laparoscopic entrance holes will be closed with aesthetic technique, the rate of wound infection is very low, it does not require wound care.
There is no obstacle/restriction in terms of sexual intercourse after obesity and bariatric surgery.
There is no medical obstacle to getting pregnant after losing your excess weight in the first 18 months following bariatric and metabolic surgery.
Do not neglect to do sports to prevent skin sagging after obesity surgery.
Post-bariatric aesthetics after bariatric surgery can completely change depending on the demands of the patients. It may be needed in some patients. 18 months after your surgery is the ideal time for post-bariatric aesthetic procedures.
