OAGB to sleeve conversion is a revisional bariatric procedure performed for patients experiencing bile reflux, marginal ulcer, dumping, reactive hypoglycemia, or complications from the original OAGB. The procedure removes the loop bypass configuration and reconstructs the stomach into a sleeve gastrectomy, eliminating bile exposure to the stomach and esophagus and simplifying the anatomy for improved long‑term stability.

The OAGB loop is taken down, the gastric pouch is reshaped, and the stomach is reconstructed into a sleeve gastrectomy. The small intestine is restored to normal continuity. This eliminates bile reflux, reduces dumping, and provides a restrictive tool for weight control when appropriate.

Benefits include elimination of bile reflux, reduced dumping, improved glycemic stability, simplified anatomy, and removal of the loop bypass configuration. Patients with marginal ulcer or bile gastritis often experience rapid symptom relief.

Candidates include patients with bile reflux, esophagitis, gastritis, marginal ulcer, dumping, reactive hypoglycemia, complications from the OAGB loop, or those who prefer a restrictive procedure after OAGB takedown.

The procedure is performed laparoscopically. The OAGB loop is taken down, the stomach is reshaped into a sleeve, and the small intestine is restored to normal continuity. Most patients go home the same day or the next morning.

Risks include bleeding, leak, stricture, reflux, nutritional deficiencies, and weight regain if long‑term habits are not maintained. Revisional surgery carries slightly higher risk due to scar tissue.

Days 1–3: hydration, gentle movement, pain control. Week 1: liquids. Week 2: soft foods. Weeks 3–4: gradual return to normal routines. By 30 days: improved energy and symptom relief.

Patients converting for bile reflux typically experience symptom resolution with minimal weight change. Patients converting for weight regain may experience modest fat loss over 12–18 months.

Dr. Nestor de la Cruz‑Muñoz is a nationally recognized bariatric and metabolic surgeon with extensive experience in complex revisional surgery. His expertise ensures safe OAGB takedown, precise sleeve reconstruction, and durable long‑term outcomes.

Most patients lose 22–28% of total body weight (TBWL) over 12–18 months when weight regain was present. Patients converting for bile reflux without weight regain may experience minimal weight change.

Conversion to sleeve may improve dumping, stabilize glucose levels, and eliminate bile exposure. Metabolic improvements vary based on baseline anatomy and goals.

Long‑term success requires protein‑forward nutrition, resistance training, avoiding slider foods, maintaining muscle mass, and consistent metabolic follow‑up.

Sleeve gastrectomy may improve bile reflux but may worsen acid reflux in some patients. Patients with severe GERD may benefit more from conversion to gastric bypass. Hiatal hernia repair is performed when needed.

Future revision options include conversion to gastric bypass for reflux, conversion to SADI‑S or DS for metabolic failure, or endoscopic revision depending on anatomy and goals.

Preserving lean mass is essential. Patients are guided to prioritize protein intake, resistance training, hydration, and body composition monitoring.

Most insurers cover revisional surgery when medical necessity is documented, including bile reflux, marginal ulcer, or complications from OAGB.

Pre‑op requirements may include bloodwork, imaging, endoscopy, nutrition consultation, psychological evaluation, and medication adjustments.

Nutrition progresses from clear liquids to full liquids, purees, soft foods, and then regular textures. Protein goals and vitamin supplementation are essential.

Early walking begins immediately after surgery. Light activity continues through week 2. Resistance training typically begins at week 4–6.

Miami is a major hub for patients from Latin America and the Caribbean. Our team supports travel coordination, virtual follow‑up, and streamlined pre‑op evaluation.