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The video presents technical steps for Laparoscopic Reversal of Roux-en-Y Gastric Bypass (RYGB) to normal anatomy, and results of pre and post-op metabolic testing. The patient underwent RYGB at another institution (BMI 46). Two years after RYGB (BMI 25), presented with recalcitrant hyperinsulinemic hypoglycemia episodes and hypoglycemia unawareness. A laparoscopic gastrostomy was placed in the excluded stomach. A meal test (MT) administered orally and through the gastrostomy showed altered insulin and glycemic responses through the RYGB. Laparoscopic reversal was performed. Patient symptoms subsided; and 6 months later (BMI 29), a MT showed normal insulin and glycemic profiles.