title: Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass.
abstract: One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4].
  
  
  
  We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014. One year later, she consulted for recurrent heartburns. An upper GI endoscopy showed pouchitis and bile reflux in the esophagus. Medical treatment of gastroesophageal reflux disease was ineffective. We decided to convert the OAGB to a Roux-en-Y gastric bypass (RYGB).
  
  
  
  In this video, we show how to revise an OAGB to treat chronic bile reflux, by converting the procedure to a standard RYGB. The intervention starts by restoring the normal anatomy of the small bowel, with the resection of the gastrojejunal anastomosis, which was located at 250-cm du Treitz's ligament. Then, the gastric pouch is created. A standard Roux-en-Y gastric bypass is performed.
  
  
  
  The resection of the gastrojejunal anastomosis allows fashioning the Roux-en-Y limb with the classical measures. This technique allows a conversion to a standard RYGB and is effective in treating the biliary reflux.
authors.affiliation: Department of Digestive Surgery, Archet II Hospital, University of Nice Sophia Antipolis, 151 Route de Saint-Antoine, 06200, Nice, France.
authors.forename: Imed Ben
authors.initials: IB
authors.lastname: Amor
authors.affiliation: Department of Digestive Surgery, Archet II Hospital, University of Nice Sophia Antipolis, 151 Route de Saint-Antoine, 06200, Nice, France. nicpetrucciani@hotmail.it.
authors.forename: Niccolo
authors.initials: N
authors.lastname: Petrucciani
authors.affiliation: Department of General Surgery, CHU Hospital, Jean Monnet University, Avenue Albert Raimond, 42270, Saint Etienne, France.
authors.forename: Radwan
authors.initials: R
authors.lastname: Kassir
authors.affiliation: Department of Digestive Surgery, Archet II Hospital, University of Nice Sophia Antipolis, 151 Route de Saint-Antoine, 06200, Nice, France.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Munifi
authors.affiliation: Department of Digestive Surgery, Archet II Hospital, University of Nice Sophia Antipolis, 151 Route de Saint-Antoine, 06200, Nice, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Piche
authors.affiliation: Department of Digestive Surgery, Archet II Hospital, University of Nice Sophia Antipolis, 151 Route de Saint-Antoine, 06200, Nice, France.
authors.forename: Tarek
authors.initials: T
authors.lastname: Debs
authors.affiliation: Department of Digestive Surgery, Archet II Hospital, University of Nice Sophia Antipolis, 151 Route de Saint-Antoine, 06200, Nice, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
mesh_terms: D001655:Bile Reflux / Q000209:etiology / Q000601:surgery; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation / Q000379:methods*
keywords: Conversion; Gastroesophageal reflux; Mini gastric bypass; Omega loop gastric bypass; Roux-en-Y gastric bypass; Surgical technique