MagDI to SADI conversion is a revisional bariatric procedure performed for patients who experience inadequate weight loss, weight regain, metabolic failure, or insufficient hormonal response after a MagDI procedure. The revision removes the magnetic compression anastomosis and reconstructs the anatomy into a SADI‑S, providing stronger metabolic effect, more durable long‑term weight loss, and improved hormonal signaling.

The magnetic anastomosis is taken down, the stomach is shaped into a sleeve gastrectomy if needed, and the duodenum is divided just beyond the pylorus. The ileum is brought up and connected to the duodenum in a single‑anastomosis configuration. This reduces calorie absorption, enhances metabolic signaling, and provides a more potent and durable weight‑loss effect than MagDI alone.

Benefits include stronger metabolic improvement, more durable long‑term weight loss, reduced hunger, improved glycemic control, and correction of inadequate response to MagDI. SADI‑S offers a more powerful hormonal and metabolic effect while maintaining a single‑anastomosis design.

Candidates include patients with inadequate weight loss after MagDI, weight regain, metabolic failure, insufficient hormonal response, or those seeking a more powerful metabolic procedure.

The procedure is performed laparoscopically. The magnetic anastomosis is taken down, 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.

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, and 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 MagDI alone.

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

Most patients lose 22–28% of total body weight (TBWL) over 12–18 months when weight regain or inadequate weight loss was present.

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

Long‑term success requires protein‑forward nutrition, resistance training, avoiding slider foods, maintaining muscle mass, and consistent metabolic follow‑up.

SADI‑S may improve reflux in some patients but may worsen it in others. Patients with severe GERD may benefit more from conversion to gastric bypass. 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. Patients are guided to prioritize protein intake, resistance training, hydration, and body composition monitoring.

Insurance coverage varies because MagDI is an emerging procedure. Revisional surgery may be covered when medical necessity is documented.

Pre‑op requirements may include bloodwork, imaging, endoscopy, nutrition consultation, psychological evaluation, and medication adjustments.

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

Early walking begins immediately after surgery. Light activity continues through week 2. Resistance training typically begins at week 4–6.

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.