Petrucciani N, et al. - Researchers here described the case of a 31-year-old woman with a BMI of 37 kg/m². The patients underwent an open Nissen fundoplication in 2010 and surgical revision in 2012 with redo of the Nissen fundoplication. They described important technical steps of this procedure. Dysphagia and obesity complicated by invalidating arthrosis were her presenting complaints. Esophageal dilatation and cardial stenosis were detected in the barium swallow test. Incomplete waves and high pressure at the lower esophageal sphincter were revealed in manometry. Conversion of the Nissen fundoplication to Roux-en-Y gastric bypass (RYGB) was performed on this patient. In the intervention, complete dissection of the gastric valve and the hiatal region from right to left were done. This was followed by the creation of a short gastric pouch taking care to exclude the gastric fundus that is also partially resected. A hand-sewn gastro-jejunal anastomosis was done; this was slightly larger than done for conventional bypass. Then they performed an RYGB with 50-cm bilio-pancreatic and 150-cm alimentary limb. Outcomes suggest that dysphagia, which may represent a complication of the fundoplication, could be treated with the conversion of Nissen fundoplication to RYGB; this procedure is identified as effective for managing obesity and gastroesophageal reflux disease.