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Single-Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S is a simplified duodenal switch in which a loop duodeno-ileostomy is performed instead of the classical Roux-en-Y diversion. The preservation of the pylorus makes unnecessary the bile diversion. The operation is simpler, shorter and has the advantage of less number of anastomosis and no mesenteric opening. SADI-S has been performed in our Department since May-2007 over more than 100 patients. The mean long-term excess weight is around 100%, with only 1% of failures and 3% cases of recurrent hypoproteinemia. Long remission of diabetes is obtained in more than 90% of the cases.