Background

Endoscopic sleeve gastroplasty (ESG) is a relatively new weight loss procedure that has been increasing in prevalence in the past decade since its inception. Literature shows slightly lower weight loss but improved safety profile associated with the procedure as compared with operative interventions; however, long-term data is limited due to its recency. Reports on post-procedural revisions of ESG describe conversion to sleeve gastrectomy but none so far document single-stage conversion to a Roux-en-Y gastric bypass (RYGB). Here we report the case of a 22-year-old female patient who presented to our clinic after undergoing an ESG at an outside facility 18 months prior. She endorsed significant symptoms associated with gastroesophageal reflux disease (GERD) since her initial procedure and was found to have dehiscence of the ESG on upper endoscopy. She was taken to the operating room for robotic-assisted laparoscopic conversion to a RYGB. She tolerated the operation well and recovered well post-operatively with improvement in symptoms. An upper GI study performed on post-op day 1 demonstrated no leak. She was discharged home on post-op day 2 and was found to be recovering well at her initial post-operative evaluation.