Band to SADI‑S conversion is a revisional bariatric procedure for patients who experienced inadequate weight loss, weight regain, band intolerance, reflux, dysphagia, esophageal dilation, or complications from a gastric band. The procedure removes the band and scar capsule, creates a sleeve gastrectomy if needed, and connects the duodenum to the ileum in a single-anastomosis configuration. SADI‑S provides powerful metabolic improvement and long-term durability.

The gastric band and surrounding scar tissue are removed. A sleeve gastrectomy is created or revised. The duodenum is divided just beyond the pylorus, and the ileum is brought up and connected to the duodenum. This reduces calorie absorption, improves metabolic signaling, and provides strong long-term weight regulation.

Benefits include powerful metabolic improvement, strong appetite suppression, durable long-term weight loss, elimination of band-related symptoms, and reduced hunger. SADI‑S is especially effective for patients with severe metabolic disease or significant weight regain.

Candidates include patients with inadequate weight loss after banding, weight regain, band intolerance, dysphagia, reflux, esophageal dilation, pouch dilation, band slippage, erosion, or complications. Patients with severe metabolic disease benefit significantly from SADI‑S conversion.

The procedure is performed laparoscopically. The band and capsule are removed, the stomach is shaped into a sleeve, and the duodenum is divided. The ileum is connected to the duodenum in a single-anastomosis configuration. Most patients go home the next day.

Risks include bleeding, leak, stricture, nutritional deficiencies, diarrhea, bile reflux, and weight regain if long-term habits are not maintained. Revisional surgery carries slightly higher risk due to scar tissue. High-volume experience reduces complication rates.

Days 1–3: hydration, ambulation, pain control. Week 1: liquids. Week 2: soft foods. Weeks 3–4: gradual return to normal routines. By 30 days: improved energy, reduced hunger, early metabolic improvements.

Patients typically experience strong metabolic improvement and steady fat loss over 12–18 months. SADI‑S offers more durable long-term results than restrictive procedures alone.

Dr. Nestor de la Cruz‑Muñoz is a nationally recognized bariatric and metabolic surgeon with extensive experience in complex revisional surgery and advanced metabolic procedures such as SADI‑S. His expertise ensures safe band removal and precise duodenal switch reconstruction.

Most patients lose 33–38% of total body weight (TBWL) over 12–18 months. Results depend on adherence to nutrition, activity, and follow-up.

SADI‑S conversion offers powerful improvement in type 2 diabetes, insulin resistance, hypertension, dyslipidemia, sleep apnea, and fatty liver disease. Many patients experience rapid metabolic improvement.

Long-term success requires protein-forward nutrition, resistance training, avoiding slider foods, maintaining muscle mass, and consistent metabolic follow-up. Body composition monitoring is essential to prevent metabolic slowdown.

SADI‑S may improve reflux in some patients but may worsen it in others. Patients with severe GERD may benefit more from bypass conversion. Hiatal hernia repair is performed when needed.

Future revision options include limb length adjustments, sleeve tightening, or conversion to full duodenal switch (DS) for maximal metabolic effect.

Preserving lean mass is essential for long-term success. Patients are guided to prioritize protein intake, resistance training, hydration, and body composition monitoring to protect metabolic rate.

Most insurers cover revisional surgery when medical necessity is documented, including band complications, inadequate weight loss, or intolerance. Requirements may include imaging, endoscopy, and medical clearance.

Pre-op requirements may include bloodwork, imaging, endoscopy, nutrition consultation, psychological evaluation, and medication adjustments. High-risk patients may require additional testing.

Nutrition progresses from clear liquids to full liquids, purees, soft foods, and then regular textures. Protein goals and vitamin supplementation are essential to prevent deficiencies.

Early walking begins immediately after surgery. Light activity continues through week 2. Resistance training typically begins at week 4–6 to support muscle preservation and metabolic health.

Miami is a major hub for patients from Latin America and the Caribbean. Our team supports travel coordination, virtual follow-up, and streamlined pre-op evaluation for international patients.