Robotic SADI-S is a minimally invasive FDA approved surgical intervention for obesity.  It may be performed as an initial procedure or as a secondary procedure for patients who have already undergone a sleeve gastrectomy and desire additional weight loss.  The procedure combines the sleeve gastrectomy, removing approximately 80% of the stomach, with bypassing a large portion of the small intestine by attaching the ileum (last part of the small intestine) to the duodenum (first part of small intestine right after the stomach).  

The procedure not only decreases the size of the stomach, but also creates malabsorption by altering the location of the small intestine.  However, the size of the stomach is larger than with a gastric bypass.

The SADI-S typically provides approximately 80% of excess weight loss at 1.5 years, which is more than both the Roux-en-Y gastric bypass and sleeve gastrectomy.  Additionally, the incidence of weight recurrence following surgery tends to be lower (13-17%) than sleeve gastrectomy or gastric bypass.   It is especially helpful for individuals with higher BMIs (>50) and/or diabetes.

Although SADI-S can be an excellent tool for weight loss and improvement of other medical conditions, it does require greater adherence to long-term vitamin, dietary, and protein supplementation due to increased malabsorption.  It is also not suitable for individuals with severe gastroesophageal reflux disease or history of frequent kidney stones.