This video is about a female patient with angastric bypass with unexplained nausea and vomiting. The patient was readmitted 2 weeks after surgery. She had a normal CT scan with passage of contrast into the Roux limb. EGD showed normal pouch but some difficulty in passing the scope into the roux limb, it would go into the blind pouch. Since contrast passed, we initiated supportive care and started TPN through a PICC line. She eventually was able to eat and was discharged home. She returned again with nausea and vomiting and was taken for a diagnostic laparoscopy. This showed kinking and folding of the roux limb and lysis of adhesions was attempted. This was unsuccessful so a revision of the gastrojejunal anastomosis was undertaken. The was difficult and some technical pearls are discussed.