A 50-year-old male with a previous history of morbid obesity and a BMI of 50 kg/m2 (145 kg) plus high blood pressure and OSA (treated with CPAP) underwent a laparoscopic sleeve gastrectomy three years ago. He lost 55kg, reaching a BMI of 32 Kg/m2 with resolution of OSA. Then he progressively regained 10 kg and currently has a BMI of 37 Kg/m2. There is no hiatal hernia or reflux, and he still requires treatment for high blood pressure. He is seeking counseling for revisional bariatric surgery. Which would be your approach?
