Sleeve to MagDI conversion is a revisional bariatric procedure for patients who experience inadequate weight loss, weight regain, metabolic disease, or sleeve-related complications. MagDI uses magnetic compression technology to create a controlled gastro‑duodenal or gastro‑jejunal anastomosis without stapling or suturing. This adds a metabolic bypass to the existing sleeve, improving weight loss and metabolic outcomes while preserving pyloric function.

The existing sleeve is evaluated and revised if necessary. Magnetic compression rings are placed endoscopically or laparoscopically to create a controlled anastomosis between the stomach and small intestine. Over several days, the magnets create a precise, standardized connection that enhances metabolic signaling and reduces calorie absorption.

Benefits include improved metabolic outcomes, enhanced weight loss, reduced hunger, improved satiety, and a simplified single‑anastomosis configuration. MagDI avoids stapling at the anastomosis and preserves pyloric function, reducing dumping and improving tolerance.

Candidates include patients with inadequate weight loss after sleeve, weight regain, metabolic disease, sleeve dilation, functional complications, or those seeking a less invasive revisional option compared to traditional bypass procedures.

The procedure is performed laparoscopically and/or endoscopically. The sleeve is inspected and revised if needed. Magnetic rings are placed to create a controlled anastomosis. Most patients go home the same day or the next morning.

Risks include bleeding, leak, stricture, delayed anastomosis formation, nutritional deficiencies, and weight regain if long-term habits are not maintained. Revisional surgery carries slightly higher risk due to scar tissue.

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 improved metabolic outcomes and steady fat loss over 12–18 months. MagDI offers more durable results than sleeve alone while avoiding the complexity of multi‑anastomosis procedures.

Dr. Nestor de la Cruz‑Muñoz is a nationally recognized bariatric and metabolic surgeon with extensive experience in advanced revisional procedures and emerging technologies such as magnetic anastomosis. His expertise ensures safe sleeve revision and precise MagDI creation.

Most patients lose 24–30% of total body weight (TBWL) over 12–18 months after conversion. Results depend on adherence to nutrition, activity, and follow-up.

MagDI conversion improves insulin sensitivity, fasting glucose, blood pressure, lipid profiles, and fatty liver disease. Improvements vary based on baseline metabolic status.

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.

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

Future revision options include limb length adjustments, sleeve tightening, conversion to OAGB, RYGB, SADI‑S, or DS depending on metabolic needs.

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

Insurance coverage varies because MagDI is an emerging technology. Documentation of medical necessity, sleeve complications, or metabolic disease may be required.

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.