SADI-S (single anastomosis duodeno-ileal bypass with sleeve gastrectomy) is a newer variant of duodenal switch surgery. The surgery has been around for about 30 years, helping obese patients control their weight. With SADI-S, one intestinal bypass is made, rather than two. That means less time in surgery and lower risk of intestinal leakage. The two-step laparoscopic procedure begins with the removal of 80 percent of the stomach. The process slims down the stomach to a cylinder-shaped “sleeve” that will hold much less food. That results in a much smaller stomach and also suppression of the appetite-triggering hormone ghrelin.