Robotic revision of vertical band gastroplasty to gastric bypass. Joseph Mercy Livingston Hospital, Howell MI This 77year-old female patient had a history of open cholecystectomy, appendectomy, and vertical banded gastroplasty in 1995. Unfortunately, even though she sustained excellent postoperative weight loss, she suffered from chronic gastric outlet obstruction symptoms requiring 10 EGDs with dilations of the band site. She was not considered for revisional surgery. In the interim, she had a large ventral hernia repaired with 20x20cm intraabdominal mesh. About 23 years after her initial bariatric surgery, she had an obstructing common bile duct stone requiring ERCP for treatment. This procedure caused acute inflammation and irritation of the VBG site, causing her to have severe gastric outlet obstruction symptoms on several occasions and three more EGDs with dilations. Ultimately, she had an ER visit for chest pain with nausea and vomiting, where a CT scan showed an acute obstruction at the VBG. She recovered, and was referred to our office for revisional bariatric surgery. We performed an elective extensive lysis of adhesions, with dissection of the VBG and partial gastrectomy with revision to Roux-en-Y gastric bypass. Postoperatively, she had an uneventful recovery and at 6 months continued to tolerate solid food with no vomiting. She had excellent postoperative resolution of her class 2 obesity as well. The video demonstrates her presentation, workup, imaging studies, surgery with focus on technical aspects of this complex revision, and postoperative course.