Gastric Sleeve Revision to Mini Gastric Bypass

Conversion of sleeve gastrectomy to mini-gastric bypass is an established revisional option for patients who experience significant weight regain or inadequate weight loss after the initial sleeve procedure. The main indications include recurrence of obesity-related comorbidities, severe or refractory gastroesophageal reflux disease, sleeve dilation, and poor long-term satiety despite appropriate dietary compliance. Mini-gastric bypass offers both restrictive and malabsorptive mechanisms and can provide effective metabolic control in selected patients. Careful preoperative evaluation is essential and should include endoscopy, imaging, and nutritional assessment to identify anatomical or functional causes of failure. Contraindications include severe malnutrition, uncontrolled psychiatric disease, active substance abuse, and poor adherence to postoperative follow-up. Patients with complex foregut anatomy or those at high risk for bile reflux require particular caution. When patient selection is appropriate, conversion to mini-gastric bypass can achieve durable weight loss and improvement of metabolic outcomes with acceptable morbidity.