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Conversion of a sleeve gastrectomy into a Roux-en-Y Gastric Bypass for the treatment of GERD in morbid obese patients It is mandatory to assess GERD in morbid patients before undergoing a bariatric surgical procedure. Surgical repair of the crura must be considered for patients with hiatal hernia who are unsuitable for a Roux-en-Y gastric Bypass. Sleeve gastrectomy patients with GERD may experience insufficient weight loss, esophagitis and a decreased quality of life. Surgical revision is the definitive treatment for these issues. Conversion of the sleeve gastrectomy into Roux-en-Y gastric bypass is the gold standard. In some cases this revisional bariatric surgery may pose a technical challenge. Dr. Antonio M Lacy and Dr. Ricard Corcelles dealt with these issues live from the operating room.