Single-anastomosis duodenal switch (SADS) procedures offer a powerful metabolic surgery option with potentially technical advantages during surgery. While uncommon, significant bile reflux symptoms can develop in the post operative period. This can lead to symptomatic bile reflux gastritis and esophagitis. Management of these symptoms can be accomplished with a variety of of non operative and operative interventions. Should conservative or medical therapy be insufficient, surgical options can be considered. This video case report highlights a potential management option: the laparoscopic conversion of a SADS to RYGB anatomy. We describe the technical aspects of the procedure and the initial post operative follow up.