Here we present the case of a 43 years-old female patient who underwent one-step revisional procedure: LAGB removal and MGB/OAGB realization. The patients had a pre-LAGB BMI of 40,1 kg/m2 ; one year after LAGB positioning, she reached a BMI of 28 kg/m2 but after 5 years a BMI of 42,6 kg/m2 was reached. For this reason, the patient was scheduled to receive an MGB/OAGB. Additionally, in the pre-operative evaluation, the patient was found to have a new-onset type 2 diabetes mellitus (HbA1c = 7,2%).