Sleeve to OAGB conversion is a revisional bariatric procedure performed for patients who experience inadequate weight loss, weight regain, metabolic disease, or sleeve-related complications. The procedure maintains or revises the sleeve and adds a powerful intestinal bypass by creating a long gastric pouch connected to the small intestine in a single-anastomosis configuration. OAGB provides strong metabolic improvement and durable long-term weight loss.

The existing sleeve is evaluated and revised if necessary. A long, narrow gastric pouch is created. The small intestine is measured and connected to the pouch in a single-anastomosis loop. This configuration reduces calorie absorption, improves metabolic signaling, and enhances long-term weight regulation.

Benefits include strong metabolic improvement, excellent weight loss, reduced hunger, improved satiety, and durable long-term outcomes. OAGB is especially effective for patients with significant weight regain or metabolic disease after sleeve gastrectomy.

Candidates include patients with inadequate weight loss after sleeve, weight regain, metabolic disease, sleeve dilation, functional complications, or those seeking stronger metabolic outcomes than the sleeve alone can provide.

The procedure is performed laparoscopically. The sleeve is inspected and revised if needed. A long gastric pouch is created, and the small intestine is connected to the pouch in a single-anastomosis configuration. Most patients go home the next day.

Risks include bleeding, leak, stricture, bile reflux, marginal ulcer, 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, ambulation, pain control. Week 1: liquids. Week 2: soft foods. Weeks 3–4: gradual return to normal routines. By 30 days: improved energy, reduced hunger, early metabolic improvements.

Patients typically experience strong metabolic improvement and steady fat loss over 12–18 months. OAGB offers more durable long-term results than sleeve gastrectomy alone.

Dr. Nestor de la Cruz‑Muñoz is a nationally recognized bariatric and metabolic surgeon with extensive experience in complex revisional surgery and advanced metabolic procedures such as OAGB. His expertise ensures safe sleeve revision and precise single-anastomosis reconstruction.

Most patients lose 25–32% of total body weight (TBWL) over 12–18 months after conversion. Results depend on adherence to nutrition, activity, and follow-up.

OAGB conversion offers strong improvement in type 2 diabetes, insulin resistance, hypertension, dyslipidemia, sleep apnea, and fatty liver disease.

Long-term success requires protein-forward nutrition, resistance training, avoiding slider foods, maintaining muscle mass, and consistent metabolic follow-up. Body composition monitoring is essential.

OAGB may improve reflux in some patients but may worsen bile reflux in others. Patients with severe GERD may benefit more from RYGB conversion. Hiatal hernia repair is performed when needed.

Future revision options include limb length adjustments, pouch resizing, conversion to RYGB for bile reflux, or conversion to SADI‑S or DS for metabolic failure.

Preserving lean mass is essential for long-term success. 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 inadequate weight loss, metabolic disease, or sleeve complications.

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.