SADI-S Surgery

Conveniently located to serve London, Greater London, Birmingham, and Manchester.

SADI-S surgery is an ideal weight-reduction procedure for patients with a BMI over 50 or for patients who would like to improve their weight loss after gastric sleeve surgery. This procedure is performed by medical-weight-loss expert Mr. Georgios Vasilikostas. Thanks to his years of experience and training, Mr. Vasilikostas is the perfect choice for patients considering undergoing SADI-S surgery in London.

What IsSADI-S Surgery?

SADI-S (Single Anastomosis Duodeno-Ileal bypass with Sleeve gastrectomy) surgery is also commonly called loop DS or single-anastomosis DS. This innovative bariatric procedure can be performed in one or two stages.

It is a popular second-stage procedure for patients who have already undergone gastric sleeve surgery. In these cases, SADI surgery can create further weight reduction or address weight regain.

SADI-S surgery also an excellent one-stage procedure for morbidly obese patients who are interested in achieving major weight reduction.

Patients who undergo SADI-S surgery typically lose more weight than with any other type of bariatric surgery, including standard gastric bypass surgery, mini-gastric bypass surgery, and sleeve gastrectomy surgery. The procedure results in an average reduction of 80% to 85% of excess body weight, or 35% to 45% of total weight.

Statistically, SADI-S surgery creates the best long-term weight-loss results out of all bariatric procedures, and it has the lowest incidence of weight regain. This procedure is also the least likely to result in inadequate weight loss.

Additionally, SADI-S surgery provides the most effective results in terms of reducing obesity-related comorbidities. The chance of diabetes resolution is particularly high with this bariatric procedure, higher than with any other form of bariatric surgery.

How Does SADI-S Surgery Work??

SADI-S surgery aids in weight reduction in a number of ways. It modifies gut hormones like ghrelin, leptin, and GLP-1. These hormones are associated with feelings of hunger and satiety. The hormonal changes triggered by SADI-S surgery ensure that patients have a smaller appetite and feel satiated for a longer period of time after consuming less food.

Additionally, by bypassing a large section of the small intestine, SADI-S surgery reduces the amount of fat and calories absorbed by the body while eating. This leads to a reduction in weight.

To ensure optimal weight loss, patients must pair their SADI-S surgery with changes in diet and lifestyle as directed by Mr. Vasilikostas. Failure to do so can potentially impact the efficacy of the surgery.

Ideal Candidates for SADI-S Surgery

The most common candidates for the SADI-S procedure are patients who want to enhance weight loss after gastric sleeve surgery or who have experienced weight regain after gastric sleeve surgery.

Patients who are morbidly obese and have a BMI over 50 are also considered to be good candidates for SADI-S surgery. Additionally, people who have a BMI of 35 to 49 and are suffering from issues such as heart disease, metabolic syndrome, or Type 2 diabetes are excellent candidates.

The procedure is especially ideal for patients with Type 2 diabetes, since it offers even more effective glucose regulation in comparison to other bariatric procedures.

The SADI-S Surgery Consultation

When patients meet with Mr. Vasilikostas for a SADI-S consultation, he will ask them a series questions regarding their weight-loss goals, health, and lifestyle. This may include questions about past medical procedures, previous weight-reduction attempts, allergies, current medications, and pre-existing health conditions. He will also perform a physical examination and may order various lab tests.

Next, Mr. Vasilikostas will walk the patient through the details of the SADI-S surgery process. He will describe both procedures in detail and will give the patient a clear idea of their potential results. He will create a safe and healthy diet and exercise plan that takes the patients’ needs and goals into account. This plan must be followed as closely as possible.

Patients will be required to adopt a liver shrinkage diet two weeks before the date of their SADI-S surgery. Reducing the size of the liver makes it easier to perform the surgical procedure.

beautiful happy mature woman

Step #1: Gastric Sleeve Surgery

The first step in the SADI-S procedure is gastric sleeve surgery. This minimally invasive bariatric procedure involves administration of general anaesthesia. Once it has taken effect, four to five very small incisions are made in the abdomen.

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A laparoscope (a thin tube with a light and a camera) is inserted into an incision, allowing Mr. Vasilikostas to view detailed images on an external monitor. He carefully removes 75% to 80% of the stomach, leaving behind a stomach that is the shape and size of a banana. This new stomach is basically 15% to 25% of the capacity of the whole stomach.


Step #2: Intestinal Bypass Surgery

The next step of the SADI-S procedure is intestinal bypass surgery. It can either be performed several months after gastric sleeve surgery or during the same surgical session.

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During intestinal bypass surgery, a large section of the intestine is bypassed by connecting a loop of intestine to the duodenum. This allows food to bypass areas of the intestine that would normally absorb nutrients and calories. About 3m of small bowel is still utilised for absorption of protein, carbohydrates, and fat.

Meet Mr Vasilikostas

With more than 25 years of clinical expertise and excellent results, Mr Vasilikostas is highly qualified in all aspects of weight loss management, including a wide range of medical and minimally invasive surgical procedures such as Allurion balloon, Orbera balloon, endoscopic sleeve, gastric bypass, mini-gastric bypass, gastric sleeve, SADI-S procedure and revision weight loss surgery.

portrait of Georgios Vasilikostas

After SADI-S Surgery

The details of recovery after SADI-S surgery will vary depending on whether both procedures were performed during a single surgical session. It will be vital to follow the post-surgical care instructions given by Mr. Vasilikostas during the healing process. This will reduce the chance of complications and contribute to a more comfortable recovery period.

Patients must adopt an all-liquid diet following their SADI-S procedure. This will gradually return to a solid-food diet over time. They may need to take pain-control medication while recovering from the surgery.

Patients will be encouraged to be as active as possible at the start of their recovery and to do all activities that they are comfortable doing. After one week, they can resume office-based work. Patients will be advised to avoid high-impact activities for two to three weeks and can then progressively return to all activities without any restrictions.

Because intestinal bypass surgery reduces the amount of nutrients absorbed by the body, long-term daily supplements will be required to prevent deficiencies. This will be discussed in greater detail during the consultation with Mr. Vasilikostas.

SADI-S Surgery Cost

Many aspects of SADI-S surgery can play a role in determining its overall cost. The patient’s personal support needs can affect the total price of this weight-loss option, as can their medical history. We provide bespoke personalised packages depending on each patient’s unique needs and goals.


Patients who are interested in finding out more about SADI-S surgery in London can schedule a consultation today. Contact our office to arrange an appointment with Mr. Vasilikostas.