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Endoscopic Sleeve Gastroplasty (ESG) is a restrictive endoscopic bariatric procedure that provides a reduction of the gastric volume and an alteration of the gastric motility. The volume of the stomach is reduced by approximately 70% through plication of the greater curvature of the stomach using an endoscopic suturing device. In case of failure, the surgical conversion is possible. We present a case of a patient with previous ESG with insufficient weight loss and gastro-oesophageal reflux. We performed a conversion to Roux-en-Y Gastric Bypass with satisfactory results.

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