Loop-Duodenal Switch (SADI-S/SIPS)
The Loop-Duodenal Switch, also called the SADI-S or SIPS, combines two procedures. A sleeve gastrectomy is performed first, and then, at the junction of the stomach and the small bowel (pylorus), the stomach is redirected and connected to a lower portion of the small bowel. The length of small bowel is usually around three metres. The procedure is typically performed laparoscopically, through a number of small incisions on the abdomen, under a general anaesthetic. The surgery takes around 3 to 4 hours.
How does it cause weight loss?
The loop DS is a restrictive and malabsorptive procedure. By restricting the size of the stomach, the amount of food you can eat is limited. By bypassing a section of the small bowel, the amount of calories and nutrients your body can absorb is reduced. Additionally, the remnant of the bypassed bowel aids in the metabolic response, which can improve other health conditions, such as diabetes.
How much weight can I expect to lose?
Studies have found that at one year after surgery, patients have lost 86.5% of their excess weight. At five years after surgery, patients have lost 80.7% of their excess weight. These amounts are averages, and the amount of weight loss varies from individual to individual.
Sources: A. Cottam et al. “Obes. Surg.”, 2016; A. Surve et al. “Surg. Obes. Relat. Diseases.”, 2020.
How long do I need to stay in hospital?
Typically 2 to 3 nights. You may require longer if you have a complex health history.
Is the procedure safe?
The loop DS has a low complication rate, however every surgery has risks.
Short term risks can include:
- Excessive bleeding
- Blood clots
- Stomach leaks
Long term risks can include:
- Dumping syndrome with diarrhea, nausea and vomiting
Though it may seem daunting, the benefits of the surgery often outweigh the risks. Both risks and benefits should be assessed when considering surgery.
How much does the surgery cost?
Information on surgery costs can be found on the Our Costs page.
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Frequently Asked Questions
Yes, you will need a referral to see Dr Puhalla. A referral from your GP is valid for 12 months, while a referral from a specialist is valid for 3 months.
The initial consultation costs $250, with a Medicare rebate of $76. The pre-operative appointment costs $90, with a Medicare rebate of $38. You will need a valid referral to claim the Medicare rebates.
No, weight loss surgery is not currently available in the public health system.
Yes, Dr Puhalla accepts uninsured patients. You can apply to the ATO for early release of your super, for which we can assist you. Medicare rebates are available for some fees, however you are liable for all costs.s
Unfortunately, Medicare and health fund rebates do not cover the full cost of providing you with medical care. This is because the rate at which successive governments have indexed the Medicare Schedule fees has been substantially lower than increases in the Consumer Price Index (CPI) and average weekly earnings. The reality is that Medicare rebates do not cover the cost of providing you with a safe and high quality service. The fees charged by this practice have to cover all of our practice costs.
Please bring a copy of your referral, along with your personal details, including Medicare card, private health insurance, and a list of medications. You will need to fill out personal details and medical history forms on arrival.
Yes, it is essential that you see a dietitian to support you on your weight loss surgery journey. This is to ensure that you have the best possible outcome relating to your weight loss and overall health.
Dr Puhalla will discuss your options with you to help you decide the best procedure for you. Your individual preferences, lifestyle and health are considered when determining your type of surgery.
Typically, the hospital stay is one to two nights. If you are undergoing revisional surgery or have a complex medical history, you may need to stay longer.
Depending on the procedure, you will need one to two weeks off work. We can provide you with a medical certificate if required.
We recommend you start driving a week after surgery, initially limiting yourself to shorter drives before returning to normal driving.
Current wait times are around three to four weeks for appointments and surgery bookings. We also have a cancellation list, as patients often have to move their appointments, which means you may be able to be seen sooner. Please advise our team at the time of booking if you would like to put on the cancellation list.
The entire process typically takes around 8 to 12 weeks. Depending on the investigations needed, and whether or not you have private health insurance, this may be able to be shortened to around 4 weeks. We will do our best to meet your schedule, however we recommend you allow at least 8 weeks for the entire process.