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Imaging and endoscopy revealed an anatomically distorted pouch, two staple line dehiscences, and a gastro-gastric fistula (GGF). Multiple revisional options were evaluated. Due to the presence of mesh and anatomical limitations, a decision was made to perform a one-anastomosis gastric bypass (OAGB) below the mesh, guided by a calibration tube passed through the area of disruption. Laparoscopic OAGB was performed with a 150-cm biliary limb and a 3-cm gastrojejunostomy. Intraoperative leak testing was negative. The patient had an uneventful recovery and was discharged on postoperative day 3. At 18-month follow-up, she achieved a weight of 74 kg (body mass index (BMI) 25.4 kg\/m<jats:sup>2<\/jats:sup>), with complete symptom resolution and normal laboratory parameters.<\/jats:p>","DOI":"10.1007\/s11695-025-08069-z","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T03:06:44Z","timestamp":1754449604000},"page":"3953-3957","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Conversion of a Failed Vertical Banded Gastroplasty to One-Anastomosis Gastric Bypass in a Case with Gastro-gastric Fistula and Mesh Complication: A Multimedia Article"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6650-8112","authenticated-orcid":false,"given":"Mohamed","family":"Hany","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-356X","authenticated-orcid":false,"given":"Mohamed H.","family":"Zidan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1408-9628","authenticated-orcid":false,"given":"Mona S.","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5718-994X","authenticated-orcid":false,"given":"Anwar Ashraf","family":"Abouelnasr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7090-8223","authenticated-orcid":false,"given":"Nour","family":"Zayed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4000-9520","authenticated-orcid":false,"given":"Mohamed","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-3218","authenticated-orcid":false,"given":"Aly","family":"Elbahrawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0274-9608","authenticated-orcid":false,"given":"Bart","family":"Torensma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"issue":"9","key":"8069_CR1","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1007\/s002689900495","volume":"22","author":"EE Mason","year":"1998","unstructured":"Mason EE, Doherty C, Cullen JJ, Scott D, Rodriguez EM, Maher JW. 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