SADI-S Surgery on Long Island, NY
Long Island Laparoscopic Doctors (LILD) has helped thousands of patients across Long Island, NY, achieve lasting weight loss through advanced bariatric and metabolic surgery. Located in East Setauket and serving patients throughout Suffolk County and beyond, our practice is led by Hesham Atwa, M.D., FACS, FASMBS, DABS-FPMBS, one of Long Island’s most credentialed and experienced bariatric surgeons. SADI-S, the Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy, is among the advanced bariatric procedures offered at our practice for patients seeking a powerful, proven path to meaningful, lasting weight loss.
If you have struggled with severe obesity and have not found lasting results through diet, exercise, or prior weight loss surgery, SADI-S may be the right next step. Contact our office today to schedule a consultation and find out whether SADI-S is appropriate for your goals and health history.
SADI-S (Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy) is one of the most powerful weight loss surgeries available today, delivering exceptional results for patients with severe obesity or those who have not achieved lasting success with a prior bariatric procedure. At Long Island Laparoscopic Doctors (LILD), our board-certified surgical team has performed SADI-S for patients across Long Island, NY, helping them achieve transformative, long-term weight loss and resolution of obesity-related conditions.
What Is SADI-S Surgery?
SADI-S combines two proven weight loss mechanisms — restriction and malabsorption — into a single streamlined operation. It is endorsed by the American Society for Metabolic and Bariatric Surgery (ASMBS) and supported by long-term clinical data showing durable results for patients with severe obesity.
The result is a powerful metabolic surgery that consistently outperforms many traditional bariatric procedures in both short-term and long-term weight loss outcomes, while offering a simpler surgical design than the traditional duodenal switch (BPD/DS).1
Individual results vary based on starting weight, adherence to post-operative guidelines, and overall health status. Our team will work with you to set realistic, personalized goals before and after your procedure.
How Does SADI-S Work?
SADI-S is performed laparoscopically or robotically through small incisions, reducing recovery time and surgical risk compared to open procedures. The surgery involves two key steps:
Step 1: Sleeve Gastrectomy (Gastric Sleeve)
Approximately 80% of the stomach is removed, creating a narrow, tube-shaped stomach during a gastric sleeve procedure. This restricts the amount of food you can eat at one time and reduces hunger-stimulating hormones, particularly ghrelin.
Step 2: Single Intestinal Bypass
The first portion of the small intestine (the duodenum) is divided just past the stomach and reconnected to a lower segment of the small intestine (the ileum). This single anastomosis reduces the length of intestine available to absorb calories and nutrients, creating a meaningful malabsorptive effect.
Unlike the traditional Biliopancreatic Diversion with Duodenal Switch (BPD/DS), which requires two intestinal connections, SADI-S requires only one. This simplification reduces operative complexity and lowers the risk of complications while preserving much of the metabolic benefit.
According to ASMBS, SADI-S produces superior excess weight loss compared to sleeve gastrectomy alone and is associated with high rates of resolution for obesity-related conditions including type 2 diabetes, hypertension, and obstructive sleep apnea.2
Who Is a Candidate for SADI-S?
SADI-S is appropriate for a specific subset of bariatric surgery candidates. Our surgical team at Long Island Laparoscopic Doctors will conduct a thorough evaluation to determine whether SADI-S is the right procedure for you. General candidacy criteria include:
- A Body Mass Index (BMI) of 40 or higher, or a BMI of 35 or higher with one or more obesity-related comorbidities such as type 2 diabetes, hypertension, or obstructive sleep apnea
- Patients who have experienced inadequate weight loss or significant weight regain following a prior sleeve gastrectomy or other bariatric procedure
- Individuals who have not achieved sustainable results through non-surgical weight loss methods
- Patients who are medically cleared for surgery and committed to long-term lifestyle changes, including dietary modifications and lifelong nutritional supplementation
Patients with active scalp infections, open wounds, or certain autoimmune conditions may not be suitable candidates. A consultation with our team will determine whether SADI-S is the right fit for your goals.
SADI-S as a Revisional Bariatric Surgery Option
SADI-S is one of the most effective revisional bariatric surgery options available for patients whose prior sleeve gastrectomy did not produce sufficient or lasting results. Weight regain after sleeve gastrectomy is a recognized clinical challenge, affecting up to 50% of patients over time, and SADI-S addresses it directly by adding a malabsorptive component to the existing restrictive anatomy.3
If you have had a previous bariatric procedure and are considering revision weight loss surgery on Long Island, our team has extensive experience evaluating and performing revisional SADI-S procedures. We will review your surgical history, current health status, and weight loss goals to determine whether SADI-S is the right next step for you.
SADI-S vs. Other Bariatric Procedures
Understanding how SADI-S compares to other weight loss surgeries can help you make an informed decision during your consultation.
| Procedure | Mechanism | Connections | Avg. Excess Weight Loss | Complexity |
|---|---|---|---|---|
| Sleeve Gastrectomy | Restrictive only | 0 | 50–70% | Lower |
| Gastric Bypass (RYGB) | Restrictive + mild malabsorptive | 2 | 60–80% | Moderate |
| SADI-S ★ | Restrictive + malabsorptive | 1 | 80–90% | Moderate |
| BPD/DS (Duodenal Switch) | Restrictive + strong malabsorptive | 2 | 85–95% | Higher |
Weight loss percentage ranges are based on published clinical data.7,8 Individual outcomes vary.
SADI-S occupies a compelling middle ground — offering weight loss outcomes that rival the traditional duodenal switch with a simpler surgical technique and a more manageable nutritional profile post-operatively.
What to Expect: Recovery and Results
Before Surgery
Your journey at Long Island Laparoscopic Doctors begins with a comprehensive pre-operative evaluation that includes medical clearance, nutritional counseling with our certified dietitian, psychological assessment, and insurance coordination. Our team will guide you through every step of the preparation process, including assistance navigating insurance authorization for SADI-S.
Many major insurance plans cover bariatric surgery when medical necessity criteria are met. Our team will work with you to verify your benefits and support the prior authorization process.
During Surgery
SADI-S is performed under general anesthesia using laparoscopic or robotic-assisted techniques. The procedure typically takes two to three hours. Most patients are admitted to the hospital for one to two nights following surgery.
After Surgery
Recovery from SADI-S follows a structured progression:
Clear liquids and rest at home. Most patients experience mild discomfort managed with oral pain medication.
Transition to pureed and soft foods. Light activity is encouraged.
Return to most normal activities. Many patients return to desk work within two to three weeks.
Gradual dietary advancement. Significant weight loss occurs during this period.
Lifelong nutritional supplementation is required, including vitamins A, D, E, K, B12, iron, calcium, and zinc. Our dietitian will provide a personalized supplement protocol and schedule regular lab work to monitor your nutritional status and catch any deficiencies early.
Why Long Island Laparoscopic Doctors
Long Island Laparoscopic Doctors has been a trusted name in bariatric and minimally invasive surgery on Long Island for more than two decades. The practice was founded and is led by Hesham Atwa, M.D., FACS, FASMBS, DABS-FPMBS, one of the most credentialed bariatric surgeons on Long Island, alongside a team of experienced surgeons, a certified dietitian, and dedicated support staff committed to guiding patients through every stage of their weight loss journey.
Hesham Atwa, M.D., FACS, FASMBS, DABS-FPMBS
Founder and Medical Director, Long Island Laparoscopic Doctors
Dr. Atwa brings more than 20 years of experience in advanced laparoscopic, robotic, and bariatric surgery to every patient encounter. His credentials include:
- Board Certified, American Board of Surgery
- Focused Practice Designation for Bariatric Surgery, American Board of Surgery (DABS-FPMBS) — one of the highest designations available in the field
- Fellow, American College of Surgeons (FACS)
- Fellow, American Society for Metabolic and Bariatric Surgery (FASMBS)
- Chief of Surgery, Mather Northwell Health Hospital
- Director and Chief of Surgery, Director of Robotics Surgery and President of Medical Staff, St. Charles Hospital
- Designated Master Surgeon in Robotic Surgery
The practice operates a Fellowship Council-accredited Minimally Invasive, Robotic, and Bariatric Surgery fellowship — a distinction held by only a small number of private practices in the country. This accreditation reflects the practice’s standing as a high-volume, high-quality training center for the next generation of bariatric surgeons.
“Surgery has evolved over the years. Thirty years ago, we were doing procedures as open surgery. Then 25 years ago, laparoscopic surgery became an option. Over the past five years, robotic surgery has improved on those techniques.”
— Dr. Hesham Atwa, M.D., FACS, FASMBS, DABS-FPMBS
What Our Patients Say
Patients throughout Long Island trust Long Island Laparoscopic Doctors for their bariatric care.
“Dr Atwa has helped me completely change my life. With support and lifestyle changes I managed to regain control of my life. I am so grateful that I was able to have this opportunity. I feel great, I’m not tired all the time, my sleep is better and the best is being able to fit comfortably in clothes! I would recommend this doctor to anyone who is thinking about weight loss.”
— E.R., Google Review
“I feel better than I have in many years. I have finally found the time to focus on myself and with Dr. Atwa’s advice and expertise, I am happier than I have been in a long time and am reaching my weight loss goals!! He is a fantastic surgeon and wonderful doctor.”
— P.W., Google Review
“The entire staff has been more than supportive and helpful with all my medical needs. Dr. Atwa and his staff recently helped me with my plans to actively seek a healthier body and lifestyle. They have worked around my schedule without any problems, and have only been a text message away for any question I might have. They go the extra mile to assure all your medical and financial needs are considered.”
— P.S., Google Review
“I am completely satisfied with Dr Atwa and his team. They guided me through the whole pre-op testing and procedures. Dr Atwa himself was a fantastic doctor and person. He made the whole journey from start to finish a wonderful experience with fantastic results that have changed my life.”
— W.C., Google Review
Frequently Asked Questions About SADI-S Surgery
What is the difference between SADI-S and gastric bypass?
Is SADI-S reversible?
How much weight can I expect to lose with SADI-S?
Will SADI-S help with type 2 diabetes?
What are the risks of nutritional deficiency after SADI-S?
Does insurance cover SADI-S surgery?
Do I need to take vitamins for life after SADI-S?
Schedule a Consultation
Are you ready to take the next step toward lasting weight loss? The team at Long Island Laparoscopic Doctors is here to help patients across Long Island, NY — including East Setauket and the surrounding communities — explore whether SADI-S surgery is right for them.
1 American Society for Metabolic and Bariatric Surgery (ASMBS). Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy. Available: https://asmbs.org/condition_procedures/single-anastomosis-duodeno-ileal-bypass-with-sleeve-gastrectomy/. Accessed April 30, 2026.
2 American Society for Metabolic and Bariatric Surgery (ASMBS). Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy. Available: https://asmbs.org/condition_procedures/single-anastomosis-duodeno-ileal-bypass-with-sleeve-gastrectomy/. Accessed April 30, 2026.
3 Palmieri L, Pennestrì F, Raffaelli M. SADI-S, state of the art. Indications and results in 2024: a systematic review of literature. Updates Surg. 2025 Nov;77(7):2037-2050. doi: 10.1007/s13304-024-02041-9. Epub 2024 Dec 1. PMID: 39617824. Available: https://pubmed.ncbi.nlm.nih.gov/39617824/. Accessed April 30, 2026.
4 Sánchez-Pernaute A, Herrera MÁR, Ferré NP, Rodríguez CS, Marcuello C, Pañella C, Antoñanzas LL, Torres A, Pérez-Aguirre E. Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S). Obes Surg. 2022 Mar;32(3):682-689. doi: 10.1007/s11695-021-05879-9. Epub 2022 Jan 15. PMID: 35032311; PMCID: PMC8760573. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC8760573/. Accessed April 30, 2026.
5 Palmieri L, Pennestrì F, Raffaelli M. SADI-S, state of the art. Indications and results in 2024: a systematic review of literature. Updates Surg. 2025 Nov;77(7):2037-2050. doi: 10.1007/s13304-024-02041-9. Epub 2024 Dec 1. PMID: 39617824. Available: https://pubmed.ncbi.nlm.nih.gov/39617824/. Accessed April 30, 2026.
6 Sánchez-Pernaute A, Herrera MÁR, Ferré NP, Rodríguez CS, Marcuello C, Pañella C, Antoñanzas LL, Torres A, Pérez-Aguirre E. Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S). Obes Surg. 2022 Mar;32(3):682-689. doi: 10.1007/s11695-021-05879-9. Epub 2022 Jan 15. PMID: 35032311; PMCID: PMC8760573. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC8760573/. Accessed April 30, 2026.
7 Palmieri L, Pennestrì F, Raffaelli M. SADI-S, state of the art. Indications and results in 2024: a systematic review of literature. Updates Surg. 2025 Nov;77(7):2037-2050. doi: 10.1007/s13304-024-02041-9. Epub 2024 Dec 1. PMID: 39617824. Available: https://pubmed.ncbi.nlm.nih.gov/39617824/. Accessed April 30, 2026.
8 Sánchez-Pernaute A, Herrera MÁR, Ferré NP, Rodríguez CS, Marcuello C, Pañella C, Antoñanzas LL, Torres A, Pérez-Aguirre E. Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S). Obes Surg. 2022 Mar;32(3):682-689. doi: 10.1007/s11695-021-05879-9. Epub 2022 Jan 15. PMID: 35032311; PMCID: PMC8760573. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC8760573/. Accessed April 30, 2026.
9 Sánchez-Pernaute A, Herrera MÁR, Ferré NP, Rodríguez CS, Marcuello C, Pañella C, Antoñanzas LL, Torres A, Pérez-Aguirre E. Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S). Obes Surg. 2022 Mar;32(3):682-689. doi: 10.1007/s11695-021-05879-9. Epub 2022 Jan 15. PMID: 35032311; PMCID: PMC8760573. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC8760573/. Accessed April 30, 2026.
10 Palmieri L, Pennestrì F, Raffaelli M. SADI-S, state of the art. Indications and results in 2024: a systematic review of literature. Updates Surg. 2025 Nov;77(7):2037-2050. doi: 10.1007/s13304-024-02041-9. Epub 2024 Dec 1. PMID: 39617824. Available: https://pubmed.ncbi.nlm.nih.gov/39617824/. Accessed April 30, 2026.
The doctors at Long Island Laparoscopic Doctors have either authored or reviewed and approved this content.
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