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Sleeve Gastrectomy has become the most common bariatric procedure worldwide due to its good results, simplicity, and low complication rate. However, a number of patients can experience weight regain after several years. Although most of the time bariatric surgeons would prefer revision to a duodenal switch or a bypass, new evidence has shown that a re-sleeve gastrectomy is a feasible option, specially when the patient had a good initial outcome in the absence of reflux and hiatal hernia and when there is a dilation of the gastric tube. We present the case of a 34-year-old female patient who underwent a Sleeve gastrectomy 6 years ago, losing 43 kilos, from 113 to 70 kilos over 18 months (BMI 41 to 25). She maintained her weight for 3 years, but after having her second daughter she progressively regained weight. She came to the hospital with a BMI of 35, a relapse of joint disease, and sleep apnea. Weight 97, Height 1.66m. Preoperative studies showed a dilated gastric tube but no evidence of hiatal hernia or reflux. After the assessment of the multidisciplinary team, the re-sleeve surgery has been selected as the reasonable option.
