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Up to 20% of patients may present insufficient weight loss or weight regain after LRYGBP. Revision of the pouch, revision of the jejuno-jejunal anastomosis and conversion into other procedures have been described as solutions. Pouch revision and conversions may be technically demanding and can lead to an increased rate of complications, with excludes a group of patients from these surgical treatments. Dr. Ricard Corcelles and Dr. Ainitze Ibarzabal provide a surgical option for a patient with insufficient weight loss after a Roux-en-Y Gastric Bypass.